| Entity Name: | NOVUS PAIN & PHYSICAL MEDICINE - FLORIDA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 10 Oct 2019 (5 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 11 Mar 2024 (10 months ago) |
| Document Number: | L19000255765 |
| FEI/EIN Number | N/A |
| Address: | 157 BALTIMORE STREET, STE. 102, CUMBERLAND, MD 21502 |
| Mail Address: | 157 BALTIMORE STREET, STE. 102, CUMBERLAND, MD 21502 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518500263 | 2019-10-25 | 2024-07-23 | 157 BALTIMORE ST STE 100, CUMBERLAND, MD, 215022472, US | 1507 S TUTTLE AVE, SARASOTA, FL, 342392608, US | |||||||||||||||||||||||
|
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| Phone | +1 301-722-0484 |
| Fax | 8339030130 |
Authorized person
| Name | HEATHER ROBOSSON |
| Role | PRACTICE MANAGER |
| Phone | 2407273995 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | Yes |
| Taxonomy Code | 2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| Is Primary | No |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| FREAS, DUSTIN | Member | 157 BALTIMORE STREET, STE. 102, CUMBERLAND, MD 21502 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-03-11 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REINSTATEMENT | 2022-09-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-09-27 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-09-27 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-03-11 |
| REINSTATEMENT | 2022-09-27 |
| Reg. Agent Resignation | 2022-02-04 |
| Florida Limited Liability | 2019-10-10 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
