| Entity Name: | JACKSONVILLE PAIN & INJURY CENTER, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 01 Mar 2010 (15 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 16 Jun 2011 (14 years ago) |
| Document Number: | P10000018410 |
| FEI/EIN Number | 272694309 |
| Address: | 12078 SAN JOSE BLVD, JACKSONVILLE, FL, 32223, US |
| Mail Address: | 12078 SAN JOSE BLVD, JACKSONVILLE, FL, 32223, US |
| ZIP code: | 32223 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497006423 | 2012-10-01 | 2013-08-09 | 4051 PHILLIPS HWY STE 2, JACKSONVILLE, FL, 322076895, US | 4051 PHILLIPS HWY STE 2, JACKSONVILLE, FL, 322076895, US | |||||||||||||||||||
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| Phone | +1 904-647-9199 |
Authorized person
| Name | REYNALDO PARDO |
| Role | PRESIDENT/DIRECTOR |
| Phone | 9046479199 |
Taxonomy
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | HB258A |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PARDO, M.D. REYNALDO | Agent | 12078 SAN JOSE BLVD, JACKSONVILLE, FL, 32223 |
| Name | Role | Address |
|---|---|---|
| PARDO, M.D. REYNALDO | President | 12078 SAN JOSE BLVD, JACKSONVILLE, FL, 32223 |
| Name | Role | Address |
|---|---|---|
| PARDO, M.D. REYNALDO | Director | 12078 SAN JOSE BLVD, JACKSONVILLE, FL, 32223 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000115389 | ST. JOSEPH INTERVENTIONAL PAIN SPECIALISTS. | ACTIVE | 2016-10-24 | 2026-12-31 | No data | 12078 SAN JOSE BLVD, SUITE 2, JACKSONVILLE, FL, 32223 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-30 | 12078 SAN JOSE BLVD, SUITE 2, JACKSONVILLE, FL 32223 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-30 | 12078 SAN JOSE BLVD, SUITE 2, JACKSONVILLE, FL 32223 | No data |
| CHANGE OF MAILING ADDRESS | 2019-04-30 | 12078 SAN JOSE BLVD, SUITE 2, JACKSONVILLE, FL 32223 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-01-06 | PARDO, M.D., REYNALDO | No data |
| AMENDMENT | 2011-06-16 | No data | No data |
| AMENDMENT | 2010-10-04 | No data | No data |
| NAME CHANGE AMENDMENT | 2010-08-30 | JACKSONVILLE PAIN & INJURY CENTER, INC | No data |
| AMENDMENT | 2010-08-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-26 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-07-16 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-01-06 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-04-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
