| Entity Name: | CENTER FOR PAIN TREATMENT, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Apr 2019 (6 years ago) |
| Document Number: | L19000094682 |
| FEI/EIN Number | 83-4073103 |
| Address: | 4351 STONEY POINTE RD., MELBOURNE, FL, 32940 |
| Mail Address: | 4351 STONEY POINTE RD., MELBOURNE, FL, 32940 |
| ZIP code: | 32940 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477013688 | 2019-03-22 | 2022-01-18 | 989 SEBASTIAN BLVD UNIT 3, SEBASTIAN, FL, 329584879, US | 989 SEBASTIAN BLVD UNIT 3, SEBASTIAN, FL, 329584879, US | |||||||||||||||||||||
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| Phone | +1 727-617-1777 |
| Fax | 8888362203 |
Authorized person
| Name | MAXI MERCADO |
| Role | ADMINISTRATOR |
| Phone | 3216150784 |
Taxonomy
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | HF MEDICARE |
| Number | OL553 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| STERN DR. RONALD | Agent | 4351 STONEY POINTE RD., MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| STERN DR. RONALD | Authorized Member | 4351 STONEY POINTE RD., MELBOURNE, FL, 32940 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-11 |
| ANNUAL REPORT | 2023-03-07 |
| ANNUAL REPORT | 2022-02-23 |
| ANNUAL REPORT | 2021-02-14 |
| ANNUAL REPORT | 2020-04-24 |
| Florida Limited Liability | 2019-04-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
