| Entity Name: | ORLANDO PAIN CENTERS OF EXCELLENCE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 Sep 2021 (3 years ago) |
| Document Number: | L21000401496 |
| FEI/EIN Number | 87-2718389 |
| Address: | 515 West State Rd 434 Suite 201, Longwood, FL, 32750, US |
| Mail Address: | 515 West State Road 434, Suite 201, Longwood, FL, 32750, US |
| ZIP code: | 32750 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659031326 | 2021-12-22 | 2021-12-22 | 515 W STATE ROAD 434 STE 201, LONGWOOD, FL, 327505162, US | 515 W STATE ROAD 434 STE 201, LONGWOOD, FL, 327505162, US | |||||||||||||||||||||||
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| Phone | +1 407-745-1115 |
| Fax | 4077451005 |
Authorized person
| Name | JOHN GERNERT |
| Role | MD |
| Phone | 4233815699 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | No |
| Taxonomy Code | 207T00000X - Neurological Surgery Physician |
| Is Primary | Yes |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| GERNERT KIMBERLEY | Agent | 4119 WARDELL PLACE, ORLANDO, FL, 32814 |
| Name | Role | Address |
|---|---|---|
| GERNERT JOHN O | President | 4119 WARDELL PLACE, ORLANDO, FL, 32814 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-01-20 | GERNERT, KIMBERLEY | No data |
| CHANGE OF MAILING ADDRESS | 2023-01-31 | 515 West State Rd 434 Suite 201, Longwood, FL 32750 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-09 | 515 West State Rd 434 Suite 201, Longwood, FL 32750 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-20 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-03-09 |
| Florida Limited Liability | 2021-09-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
