| Entity Name: | STAGES OF LIFE MEDICAL INSTITUTE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Jan 2001 (24 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 22 Nov 2013 (11 years ago) |
| Document Number: | P01000011372 |
| FEI/EIN Number | 593698456 |
| Address: | 1917 BOOTHE CIRCLE, STE 171, LONGWOOD, FL, 32750 |
| Mail Address: | 1917 BOOTHE CIRCLE, STE 171, LONGWOOD, FL, 32750 |
| ZIP code: | 32750 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790968485 | 2007-12-17 | 2013-06-12 | 1917 BOOTHE CIRCLE, LONGWOOD, FL, 327506708, US | 1917 BOOTHE CIR, LONGWOOD, FL, 327506708, US | |||||||||||||||||
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| Phone | +1 407-679-3337 |
Authorized person
| Name | DR. DAVID S KLEIN |
| Role | PHYSICIAN |
| Phone | 4076793337 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| License Number | ME 81513 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KLEIN DAVID S | Agent | 1917 BOOTHE CIRCLE, LONGWOOD, FL, 32750 |
| Name | Role | Address |
|---|---|---|
| KLEIN DAVID S | President | 1917 BOOTHE CIRCLE, LONGWOOD, FL, 32750 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000008619 | PAIN CENTER OF ORLANDO, INC | ACTIVE | 2023-01-19 | 2028-12-31 | No data | 1917 BOOTHE CIRCLE, LONGWOOD, FL, 32750 |
| G11000079743 | PAIN CENTER OF ORLANDO, INC. | EXPIRED | 2011-08-11 | 2016-12-31 | No data | 225 WEST STATE ROAD, SUITE 205, LONGWOOD, FL, 32779, US |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2013-11-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-11-22 | 1917 BOOTHE CIRCLE, STE 171, LONGWOOD, FL 32750 | No data |
| CHANGE OF MAILING ADDRESS | 2013-11-22 | 1917 BOOTHE CIRCLE, STE 171, LONGWOOD, FL 32750 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-11-22 | 1917 BOOTHE CIRCLE, STE 171, LONGWOOD, FL 32750 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| NAME CHANGE AMENDMENT | 2011-08-03 | STAGES OF LIFE MEDICAL INSTITUTE, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-11 |
| ANNUAL REPORT | 2023-03-14 |
| ANNUAL REPORT | 2022-03-23 |
| ANNUAL REPORT | 2021-01-16 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-03-21 |
| ANNUAL REPORT | 2016-01-13 |
| ANNUAL REPORT | 2015-02-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
