| Entity Name: | PROFESSIONAL PAIN MANAGEMENT CLINIC INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 15 Jan 2009 (16 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | P09000004936 |
| FEI/EIN Number | 26-4081525 |
| Address: | 180 SW 84 AVE SUITE A, PLANTATION, FL 33324 |
| Mail Address: | 3267 DAVIE BLVD., FT. LAUDERDALE, FL 33312 |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942512447 | 2010-07-13 | 2015-05-05 | 3267 DAVIE BLVD, FORT LAUDERDALE, FL, 33312, US | 3267 DAVIE BLVD, FORT LAUDERDALE, FL, 33312, US | |||||||||||||||||||||||||||
|
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| Phone | +1 954-584-7009 |
| Fax | 9545847209 |
Authorized person
| Name | MR. EREZ COHEN |
| Role | PRESIDENT |
| Phone | 9545847009 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | OS4663 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QP3300X - Pain Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GERSHENBAUM, BART K | Agent | 180 SW 84 AVE SUITE A, PLANTATION, FL 33324 |
| Name | Role | Address |
|---|---|---|
| GERSHENBAUM, BART K | President | 180 SW 84 AVE, SUITE A PLANTATION, FL 33324 |
| Name | Role | Address |
|---|---|---|
| GERSHENBAUM, BART K | Vice President | 180 SW 84 AVE, SUITE A PLANTATION, FL 33324 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-24 | 180 SW 84 AVE SUITE A, PLANTATION, FL 33324 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-04-24 | 180 SW 84 AVE SUITE A, PLANTATION, FL 33324 | No data |
| AMENDMENT | 2011-11-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2011-11-28 | GERSHENBAUM, BART K | No data |
| AMENDMENT | 2009-10-28 | No data | No data |
| AMENDMENT | 2009-04-10 | No data | No data |
| AMENDMENT | 2009-03-11 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2009-03-11 | 180 SW 84 AVE SUITE A, PLANTATION, FL 33324 | No data |
| AMENDMENT | 2009-01-28 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J17000275612 | LAPSED | CACE16006297 | BROWARD COUNTY COURT | 2017-05-15 | 2022-05-19 | $288,771.89 | DDR SOUTHEAST FOUNTAINS, LLC, 3300 ENTERPRIZE PARKWAY, BEACHWOOD, OH 44122 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-24 |
| ANNUAL REPORT | 2016-03-03 |
| ANNUAL REPORT | 2015-03-23 |
| ANNUAL REPORT | 2014-03-03 |
| ANNUAL REPORT | 2013-04-29 |
| ANNUAL REPORT | 2012-04-30 |
| Off/Dir Resignation | 2011-11-28 |
| Amendment | 2011-11-28 |
| ANNUAL REPORT | 2011-04-26 |
| ANNUAL REPORT | 2010-01-29 |
Date of last update: 26 Jan 2025
Sources: Florida Department of State
