| Entity Name: | BORIKEN PAIN AND ANESTHESIA L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Apr 2017 (8 years ago) |
| Document Number: | L17000075480 |
| FEI/EIN Number | 82-1108367 |
| Address: | 110 Southern Oaks Drive, Plant City, FL, 33563, US |
| Mail Address: | 110 Southern Oaks Drive, Plant City, FL, 33563, US |
| ZIP code: | 33563 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245764208 | 2017-04-17 | 2021-02-05 | 3433 LITHIA PINECREST RD STE 196, VALRICO, FL, 335966302, US | 110 SOUTHERN OAKS DR, PLANT CITY, FL, 335631446, US | |||||||||||||||||||||||||||
|
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| Phone | +1 813-938-6627 |
| Fax | 8663575209 |
Authorized person
| Name | DR. ORVIL LUIS AYALA |
| Role | MEMBER |
| Phone | 8139386627 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | No |
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| Is Primary | No |
| Taxonomy Code | 208VP0000X - Pain Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| AYALA ORVIL | Agent | 110 Southern Oaks Drive, Plant City, FL, 33563 |
| Name | Role | Address |
|---|---|---|
| AYALA ORVIL | Authorized Member | 110 Southern Oaks Drive, Plant City, FL, 33563 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000095334 | NEW DAY PAIN AND WELLNESS | ACTIVE | 2018-08-27 | 2028-12-31 | No data | 110 SOUTHERN OAKS DR, PLANT CITY, FL, 33563 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-03-29 | 110 Southern Oaks Drive, Plant City, FL 33563 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-29 | 110 Southern Oaks Drive, Plant City, FL 33563 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-03-06 | 110 Southern Oaks Drive, Plant City, FL 33563 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-03-29 |
| ANNUAL REPORT | 2022-03-24 |
| ANNUAL REPORT | 2021-03-22 |
| ANNUAL REPORT | 2020-04-21 |
| ANNUAL REPORT | 2019-03-06 |
| ANNUAL REPORT | 2018-01-29 |
| Florida Limited Liability | 2017-04-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
