| Entity Name: | JACKSONVILLE PAIN CENTER, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 23 Oct 2007 (17 years ago) |
| Document Number: | P07000116180 |
| FEI/EIN Number | 26-1104719 |
| Address: | 9421 WAYPOINT PLACE, JACKSONVILLE, FL 32257 |
| Mail Address: | P.O. BOX 600290, JACKSONVILLE, FL 32260 |
| ZIP code: | 32257 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114114303 | 2007-10-01 | 2010-12-21 | PO BOX 600290, JACKSONVILLE, FL, 322600290, US | 9421 WAYPOINT PL, JACKSONVILLE, FL, 322579229, US | |||||||||||||||||||
|
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| Phone | +1 904-268-8200 |
| Fax | 9042688298 |
Authorized person
| Name | DR. HEMANT SHAH |
| Role | PRESIDENT/ OWNER |
| Phone | 9042688200 |
Taxonomy
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| License Number | ME95262 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Farah Law | Agent | 6550 St. Augustine Road, Suite 103, Jacksonville, FL 32217 |
| Name | Role | Address |
|---|---|---|
| SHAH, HEMANT MD | President | 9421 WAYPOINT PLACE, JACKSONVILLE, FL 32257 |
| Name | Role | Address |
|---|---|---|
| SHAH, HEMANT MD | Secretary | 9421 WAYPOINT PLACE, JACKSONVILLE, FL 32257 |
| Name | Role | Address |
|---|---|---|
| SHAH, HEMANT MD | Treasurer | 9421 WAYPOINT PLACE, JACKSONVILLE, FL 32257 |
| Name | Role | Address |
|---|---|---|
| SHAH, HEMANT MD | Director | 9421 WAYPOINT PLACE, JACKSONVILLE, FL 32257 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000037431 | JACKSONVILLE PAIN CENTER | ACTIVE | 2010-04-28 | 2025-12-31 | No data | P.O. BOX 600290, JACKSONVILLE, FL, 32260 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2020-03-17 | Farah Law | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-04-22 | 6550 St. Augustine Road, Suite 103, Jacksonville, FL 32217 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-02-21 | 9421 WAYPOINT PLACE, JACKSONVILLE, FL 32257 | No data |
| CHANGE OF MAILING ADDRESS | 2008-02-01 | 9421 WAYPOINT PLACE, JACKSONVILLE, FL 32257 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2022-03-09 |
| ANNUAL REPORT | 2021-03-13 |
| ANNUAL REPORT | 2020-03-17 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-03-20 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-03-05 |
| ANNUAL REPORT | 2015-02-25 |
Date of last update: 26 Jan 2025
Sources: Florida Department of State
