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  5. FLORIDA PAIN CARE, PLLC

FLORIDA PAIN CARE, PLLC

Company Details

Entity Name: FLORIDA PAIN CARE, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 25 Sep 2017 (7 years ago)
Last Event: LC DISSOCIATION MEM
Event Date Filed: 21 May 2018 (7 years ago)
Document Number: L17000199052
FEI/EIN Number 82-2947709
Mail Address: 61 W Crest Avenue, Winter Garden, FL, 34787, US
Address: 2749 Citrus Tower Blvd, Clermont, FL, 34711, US
ZIP code: 34711
County: Lake
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1114438215 2017-10-16 2019-11-21 2749 CITRUS TOWER BLVD, CLERMONT, FL, 347116699, US 2749 CITRUS TOWER BLVD, CLERMONT, FL, 34711, US

Contacts
Phone +1 352-559-0979
Fax 3527083050

Authorized person
Name DANIEL SCHAFFER
Role OWNER
Phone 3525590979

Taxonomy
Taxonomy Code 261QP3300X - Pain Clinic/Center
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FLORIDA PAIN CARE CASH BALANCE PLAN 2023 822947709 2024-10-09 FLORIDA PAIN CARE, PLLC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 3525590979
Plan sponsor’s address 2749 CITRUS TOWER BLVD., CLERMONT, FL, 34787

Signature of
Role Plan administrator
Date 2024-10-09
Name of individual signing DANIEL SCHAFFER
Valid signature Filed with authorized/valid electronic signature
FLORIDA PAIN CARE 401(K) PLAN 2023 822947709 2024-10-09 FLORIDA PAIN CARE, PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 3525590979
Plan sponsor’s address 2749 CITRUS TOWER BLVD., CLERMONT, FL, 34787

Signature of
Role Plan administrator
Date 2024-10-09
Name of individual signing DANIEL SCHAFFER
Valid signature Filed with authorized/valid electronic signature
FLORIDA PAIN CARE 401(K) PLAN 2022 822947709 2023-10-16 FLORIDA PAIN CARE, PLLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 3525590979
Plan sponsor’s address 2749 CITRUS TOWER BLVD, CLERMONT, FL, 34787
FLORIDA PAIN CARE CASH BALANCE PLAN 2022 822947709 2023-10-16 FLORIDA PAIN CARE, PLLC 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 3525590979
Plan sponsor’s address 2749 CITRUS TOWER BLVD, CLERMONT, FL, 34787
FLORIDA PAIN CARE CASH BALANCE PLAN 2021 822947709 2022-10-21 FLORIDA PAIN CARE, PLLC 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 3525590979
Plan sponsor’s address 1745 E. HIGHWAY 50 / UNIT B1, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2022-10-21
Name of individual signing DANIEL SCHAFFER
Valid signature Filed with authorized/valid electronic signature
FLORIDA PAIN CARE 401(K) PLAN 2021 822947709 2022-10-21 FLORIDA PAIN CARE, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 3525590979
Plan sponsor’s address 2749 CITRUS TOWER BLVD, CLERMONT, FL, 34787

Signature of
Role Plan administrator
Date 2022-10-21
Name of individual signing DANIEL SCHAFFER
Valid signature Filed with authorized/valid electronic signature
FLORIDA PAIN CARE CASH BALANCE PLAN 2020 822947709 2021-10-15 FLORIDA PAIN CARE, PLLC 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 3525590979
Plan sponsor’s address 1745 E. HIGHWAY 50 / UNIT B1, CLERMONT, FL, 34711
FLORIDA PAIN CARE 401(K) PLAN 2020 822947709 2021-10-13 FLORIDA PAIN CARE, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 3525590979
Plan sponsor’s address 2749 CITRUS TOWER BLVD., CLERMONT, FL, 34787
FLORIDA PAIN CARE 401(K) PLAN 2019 822947709 2020-09-30 FLORIDA PAIN CARE, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 3525590979
Plan sponsor’s address 2749 CITRUS TOWER BLVD., CLERMONT, FL, 34711
FLORIDA PAIN CARE CASH BALANCE PLAN 2019 822947709 2020-09-30 FLORIDA PAIN CARE, PLLC 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 3525590979
Plan sponsor’s address 2749 CITRUS TOWER BLVD., CLERMONT, FL, 34711

Agent

Name Role Address
SCHAFFER Daniel J Agent 61 W Crest Avenue, Winter Garden, FL, 34787

Auth

Name Role Address
Daniel Schaffer, MD PA Auth 61 W Crest Avenue, Winter Garden, FL, 34787

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2022-04-27 2749 Citrus Tower Blvd, Clermont, FL 34711 No data
REGISTERED AGENT NAME CHANGED 2022-04-27 SCHAFFER, Daniel J No data
CHANGE OF MAILING ADDRESS 2021-04-28 2749 Citrus Tower Blvd, Clermont, FL 34711 No data
REGISTERED AGENT ADDRESS CHANGED 2021-04-28 61 W Crest Avenue, Winter Garden, FL 34787 No data
LC DISSOCIATION MEM 2018-05-21 No data No data

Documents

Name Date
ANNUAL REPORT 2024-04-30
ANNUAL REPORT 2023-04-27
ANNUAL REPORT 2022-04-27
ANNUAL REPORT 2021-04-28
ANNUAL REPORT 2020-04-20
ANNUAL REPORT 2019-04-27
CORLCDSMEM 2018-05-21
ANNUAL REPORT 2018-04-29
Florida Limited Liability 2017-09-25

Related by officers

No related officers

Related by address

61 W Crest Avenue, Winter Garden, FL, 34787, US

SUPERNATURAL RX, INC. MIDTOWN ONE, LLC DANIEL SCHAFFER, M.D., P.A.

2749 Citrus Tower Blvd, Clermont, FL, 34711, US

DANIEL SCHAFFER, M.D., P.A.

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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