| Entity Name: | BRANDON PAIN MEDICINE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 04 Jun 2009 (16 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | P09000049168 |
| FEI/EIN Number | 270344958 |
| Mail Address: | 25 TREASURE DRIVE, TAMPA, FL, 33609 |
| Address: | 935 Oakfield Drive, TAMPA, FL, 33511, US |
| ZIP code: | 33511 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881821783 | 2009-06-18 | 2012-02-23 | 514 EICHEFELD DRIVE, SUITE 202, BRANDON, FL, 33511, US | 514 EICHEFELD DRIVE, SUITE 202, BRANDON, FL, 33511, US | |||||||||||||||||||
|
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| Phone | +1 813-571-7117 |
| Fax | 8135717017 |
Authorized person
| Name | DR. RAFAEL V MIGUEL |
| Role | OWNER |
| Phone | 8135717117 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| License Number | ME44537 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MIGUEL RAFAEL VMD | Agent | 25 TREASURE DRIVE, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| MIGUEL RAFAEL V | Director | 25 TREASURE DRIVE, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| MIGUEL RAFAEL VMD | President | 25 TREASURE DRIVE, TAMPA, FL, 33609 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-04-24 | 935 Oakfield Drive, TAMPA, FL 33511 | No data |
| REINSTATEMENT | 2013-06-22 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| REINSTATEMENT | 2011-10-05 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2011-10-05 | MIGUEL, RAFAEL V, MD | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-04-24 |
| REINSTATEMENT | 2013-06-22 |
| REINSTATEMENT | 2011-10-05 |
| ANNUAL REPORT | 2010-09-17 |
| Domestic Profit | 2009-06-04 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
