| Entity Name: | PALM PAIN MANAGEMENT, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 18 Sep 2023 (a year ago) |
| Document Number: | L23000433814 |
| FEI/EIN Number | 93-3492870 |
| Address: | 2055 MILITARY TRAIL N, STE 312, JUPITER, FL 33458 |
| Mail Address: | 2055 MILITARY TRAIL N, STE 312, JUPITER, FL 33458 |
| ZIP code: | 33458 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427830744 | 2023-10-20 | 2023-10-20 | 9177 SE RIVER TER, JUPITER, FL, 334691331, US | 2055 MILITARY TRL STE 312, JUPITER, FL, 334587816, US | |||||||||||||||
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| Phone | +1 561-262-4777 |
| Phone | +1 561-972-8666 |
Authorized person
| Name | LAWRENCE DEZIEL |
| Role | MGR |
| Phone | 5612624777 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DEZIEL, LAWRENCE P | Agent | 9177 SE RIVER TER, JUPITER, FL 33469 |
| Name | Role | Address |
|---|---|---|
| DEZIEL, LAWRENCE P | Manager | 9177 SE RIVER TER, JUPITER, FL 33469 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| Florida Limited Liability | 2023-09-18 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
