| Entity Name: | INTERVENTIONAL PAIN, REHAB AND REGENERATIVE CENTER OF FLORIDA, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 25 Jan 2017 (8 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L17000019651 |
| FEI/EIN Number | 815135445 |
| Address: | 2275 N Volusia Ave, ORANGE CITY, FL, 32763, US |
| Mail Address: | 2111 HONTOON RD, DELAND, FL, 32720, US |
| ZIP code: | 32763 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336687391 | 2017-02-09 | 2019-01-09 | 2111 HONTOON RD, DELAND, FL, 327204308, US | 2275 N VOLUSIA AVE, ORANGE CITY, FL, 327632833, US | |||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 386-747-9771 |
| Phone | +1 386-774-0109 |
| Fax | 3867741203 |
Authorized person
| Name | DR. GEORGE TATAW BESONG |
| Role | PRESIDENT & CEO |
| Phone | 3867479771 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME123086 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME92729 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208VP0000X - Pain Medicine Physician |
| License Number | ME92729 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| License Number | ME92729 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BESONG Sabine | Agent | 2111 HONTOON RD, DELAND, FL, 32720 |
| Name | Role | Address |
|---|---|---|
| BESONG Sabine | Manager | 2111 HONTOON RD, DELAND, 32720 |
| Name | Role | Address |
|---|---|---|
| Besong George | Dr | 2111 HONTOON RD, DELAND, FL, 32720 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000039929 | SUNFLOWER BIRTHING PLACE | ACTIVE | 2021-03-23 | 2026-12-31 | No data | 2111 HONTOON RD, DELAND, FL, 32720 |
| G19000102687 | AMABELLA ANTIAGING AND AESTHETICS | EXPIRED | 2019-09-18 | 2024-12-31 | No data | 2111 HONTOON RD, DELAND, FL, 32720 |
| G17000072219 | AMABELLA ANTI-AGING MEDICAL SPA | EXPIRED | 2017-07-04 | 2022-12-31 | No data | 2111 HONTOON RD, DELAND, FL, 32720 |
| G17000051400 | ADVANCECARE WELLNESS & WOMEN'S HEALTH | EXPIRED | 2017-05-09 | 2022-12-31 | No data | 2111 HONTOON RD, DELAND, FL, 32720 |
| G17000039243 | ADVANCECARE WELLNESS AND MEDICAL CENTER | EXPIRED | 2017-04-12 | 2022-12-31 | No data | 2111 HONTOON RD, DELAND, FL, 32720 |
| G17000012049 | ANTI-AGING, REGENERATION AND PAIN CTR | EXPIRED | 2017-02-01 | 2022-12-31 | No data | 2111 HONTOON RD, DELAND, FL, 32720 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| LC REVOCATION OF DISSOLUTION | 2023-06-02 | No data | No data |
| VOLUNTARY DISSOLUTION | 2023-03-13 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-04-06 | BESONG, Sabine | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-03-26 | 2275 N Volusia Ave, ORANGE CITY, FL 32763 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J23000558965 | ACTIVE | 2022 11932 CIDL | VOLUSIA COUNTY, FLORIDA | 2023-08-12 | 2028-11-16 | $103,657.04 | STEARNS BANK N.A., 500 13TH STREET, ALBANY, MINNESOTA 56307 |
| Name | Date |
|---|---|
| LC Revocation of Dissolution | 2023-06-02 |
| VOLUNTARY DISSOLUTION | 2023-03-13 |
| ANNUAL REPORT | 2022-04-06 |
| ANNUAL REPORT | 2021-03-13 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-03-26 |
| ANNUAL REPORT | 2018-04-15 |
| Florida Limited Liability | 2017-01-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
