| Entity Name: | DYNAMIC PAIN & WELLNESS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Sep 2015 (9 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 27 Mar 2019 (6 years ago) |
| Document Number: | L15000161232 |
| FEI/EIN Number | 47-5138029 |
| Address: | 930 Mar Walt Drive, Suite C, Fort Walton Beach, FL, 32547, US |
| Mail Address: | 930 Mar Walt Drive, Suite C, Fort Walton Beach, FL, 32547, US |
| ZIP code: | 32547 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003684697 | 2023-12-13 | 2023-12-13 | 930 MAR WALT DRIVE, UNIT C, FORT WALTON BEACH, FL, 32547, US | 5111 N 12TH AVE, PENSACOLA, FL, 325048918, US | |||||||||||||||
|
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| Phone | +1 850-226-6801 |
| Fax | 8774135104 |
Authorized person
| Name | SARAH BAILEY |
| Role | CREDENTIALING |
| Phone | 8502266801 |
Taxonomy
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| mathew mccune TCEO | Agent | 930 Mar Walt Drive, Fort Walton Beach, FL, 32547 |
| Name | Role | Address |
|---|---|---|
| MCCUNE MATHEW | Chief Executive Officer | 4490 stone bridge, DESTIN, FL, 32541 |
| Name | Role | Address |
|---|---|---|
| McCune Mike N | Exec | 125 Tranquility Dr, Crestview, FL, 32536 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000080637 | DYNAMIC PAIN & WELLNESS | ACTIVE | 2020-07-10 | 2025-12-31 | No data | 930 MAR WALT DRIVE, STE C, FORT WALTON BEACH, FL, 32547 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-09 | 930 Mar Walt Drive, Suite C, Fort Walton Beach, FL 32547 | No data |
| LC NAME CHANGE | 2019-03-27 | DYNAMIC PAIN & WELLNESS, LLC | No data |
| CHANGE OF MAILING ADDRESS | 2016-10-13 | 930 Mar Walt Drive, Suite C, Fort Walton Beach, FL 32547 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-10-13 | mathew, mccune Thomas, CEO | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-10-13 | 930 Mar Walt Drive, Suite C, Fort Walton Beach, FL 32547 | No data |
| REINSTATEMENT | 2016-10-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J24000770394 | ACTIVE | 2024 CA 0888 | ESCAMBIA CO, FL CIVIL COURT | 2024-09-30 | 2029-12-11 | $131,963.14 | AMERICAN HERITAGE FINANCIAL, LLC, 3155 GATEWAY LANE, CANTONMENT, FL 32533 |
| J24000794741 | ACTIVE | 30-2023-01364041CUBCCJC | SUPERIOR COURT OF CALIFORNIA | 2024-02-28 | 2029-12-24 | $729,494.44 | INCENTADVISE INC., 495 GRAND BLVD., 206, SANTA ROSA BEACH FL 32459 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-07-12 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-02-07 |
| ANNUAL REPORT | 2021-01-26 |
| ANNUAL REPORT | 2020-06-09 |
| ANNUAL REPORT | 2019-04-08 |
| LC Name Change | 2019-03-27 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-02-13 |
| REINSTATEMENT | 2016-10-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
