| Entity Name: | FLORIDA PHYSICAL MEDICINE & PAIN CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 14 May 2015 (10 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L15000085445 |
| FEI/EIN Number | 47-4028030 |
| Address: | 3037 ISOLA BELLA BLVD, MT. DORA, FL, 32757, US |
| Mail Address: | P.O. Box 267, Tavares, FL, 32778, US |
| ZIP code: | 32757 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457734212 | 2015-06-29 | 2015-10-14 | PO BOX 267, TAVARES, FL, 327780267, US | 601 E DIXIE AVE, STE 101, LEESBURG, FL, 347485953, US | |||||||||||||||||||||
|
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| Phone | +1 352-787-9700 |
| Fax | 3527879703 |
| Fax | 3527879700 |
Authorized person
| Name | DR. ANUREET GARG |
| Role | SOLE MEMBER |
| Phone | 3527879700 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| License Number | OS 12502 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GARG Varun | Agent | Box 267, Tavares, FL, 32778 |
| Name | Role | Address |
|---|---|---|
| GARG VARUN | Authorized Member | PO Box 267, Tavares, FL, 32778 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-04-19 | GARG, Varun | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-19 | Box 267, Tavares, FL 32778 | No data |
| CHANGE OF MAILING ADDRESS | 2016-04-27 | 3037 ISOLA BELLA BLVD, MT. DORA, FL 32757 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-04-27 |
| Florida Limited Liability | 2015-05-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
