| Entity Name: | PAIN CONSULTANTS OF WEST FLORIDA, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 20 Mar 2003 (22 years ago) |
| Document Number: | P03000033840 |
| FEI/EIN Number | 562338432 |
| Address: | 4624 N DAVIS HIGHWAY, PENSACOLA, FL, 32503, US |
| Mail Address: | 4624 N DAVIS HIGHWAY, PENSACOLA, FL, 32503, US |
| ZIP code: | 32503 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013074897 | 2007-01-02 | 2022-08-31 | 4624 N DAVIS HWY, PENSACOLA, FL, 325032337, US | 4624 N DAVIS HWY, PENSACOLA, FL, 325032337, US | |||||||||||||||
|
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| Phone | +1 850-494-0000 |
| Fax | 8504940001 |
Authorized person
| Name | PABLO CONCEPCION |
| Role | OWNER/PHYSICIAN |
| Phone | 8504940000 |
Taxonomy
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Concepcion Pablo | Agent | 4624 N DAVIS HIGHWAY, PENSACOLA, FL, 32503 |
| Name | Role | Address |
|---|---|---|
| CONCEPCION PABLO M | Director | 4624 N DAVIS HIGHWAY, PENSACOLA, FL, 32503 |
| Steichen Carrie ADO | Director | 4624 N DAVIS HIGHWAY, PENSACOLA, FL, 32503 |
| Name | Role | Address |
|---|---|---|
| Hebert Justin MD | Authorized Member | 4624 N DAVIS HIGHWAY, PENSACOLA, FL, 32503 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2017-11-20 | Concepcion, Pablo | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-01-14 | 4624 N DAVIS HIGHWAY, PENSACOLA, FL 32503 | No data |
| CHANGE OF MAILING ADDRESS | 2010-01-14 | 4624 N DAVIS HIGHWAY, PENSACOLA, FL 32503 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-01-14 | 4624 N DAVIS HIGHWAY, PENSACOLA, FL 32503 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J14000703388 | TERMINATED | 1000000631364 | ESCAMBIA | 2014-05-23 | 2034-05-29 | $ 1,854.13 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, PENSACOLA SERVICE CENTER, 3670 N L ST STE C, PENSACOLA FL325055254 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-13 |
| ANNUAL REPORT | 2024-01-17 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-17 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-03-12 |
| AMENDED ANNUAL REPORT | 2017-11-20 |
| ANNUAL REPORT | 2017-04-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
