| Entity Name: | PHYSICAL MEDICINE AND PAIN CONSULTANTS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 04 Dec 2015 (9 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L15000202626 |
| FEI/EIN Number | 81-0796170 |
| Address: | 1790 East Venice Ave., Suite 102, Venice, FL, 34292, US |
| Mail Address: | 614 Ravenna Street, Venice, FL, 34285, US |
| ZIP code: | 34292 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629436910 | 2016-02-02 | 2019-10-01 | 614 RAVENNA ST, VENICE, FL, 342853028, US | 1790 E VENICE AVE STE 102, VENICE, FL, 342923191, US | |||||||||||||||||||
|
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| Phone | +1 941-488-0074 |
| Fax | 9414882074 |
Authorized person
| Name | DAVID HABER |
| Role | OWNER |
| Phone | 9414880074 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| Is Primary | No |
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Ring Mark SCPA | Agent | 248 Nokomis Ave. S., Venice, FL, 34285 |
| Name | Role | Address |
|---|---|---|
| BLOOD JEFFREY R | Manager | 614 RAVENNA ST, VENICE, FL, 34285 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-10-11 | 1790 East Venice Ave., Suite 102, Venice, FL 34292 | No data |
| CHANGE OF MAILING ADDRESS | 2019-10-11 | 1790 East Venice Ave., Suite 102, Venice, FL 34292 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-09-18 | Ring, Mark S., CPA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-09-18 | 248 Nokomis Ave. S., Venice, FL 34285 | No data |
| LC DISSOCIATION MEM | 2019-09-03 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2020-03-04 |
| AMENDED ANNUAL REPORT | 2019-10-11 |
| AMENDED ANNUAL REPORT | 2019-09-18 |
| CORLCDSMEM | 2019-09-03 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-01-25 |
| ANNUAL REPORT | 2017-03-08 |
| ANNUAL REPORT | 2016-04-12 |
| Florida Limited Liability | 2015-12-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
