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  5. NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC

NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC

Company Details

Entity Name: NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 26 Sep 2013 (11 years ago)
Date of dissolution: 27 Sep 2024 (4 months ago)
Last Event: REINSTATEMENT
Event Date Filed: 21 Jan 2025 (15 days ago)
Document Number: P13000079567
FEI/EIN Number 46-3755923
Address: 2321 Crestover Lane, WESLEY CHAPEL, FL, 33544, US
Mail Address: 2321 Crestover Lane, WESLEY CHAPEL, FL, 33544, US
ZIP code: 33544
County: Pasco
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1326478942 2013-11-18 2013-12-09 2014 ASHLEY OAKS CIR, SUITE 101, WESLEY CHAPEL, FL, 335446400, US 2014 ASHLEY OAKS CIR, SUITE 101, WESLEY CHAPEL, FL, 335446400, US

Contacts
Phone +1 813-999-3030
Fax 8139917377

Authorized person
Name DR. JOSE DE LA TORRE
Role OWNER
Phone 8133091013

Taxonomy
Taxonomy Code 208100000X - Physical Medicine & Rehabilitation Physician
License Number ME89848
State FL
Is Primary Yes
Taxonomy Code 208VP0014X - Interventional Pain Medicine Physician
License Number ME89848
State FL
Is Primary No

Other Provider Identifiers
Issuer MEDICAID
Number 269279100
State FL
Issuer RR MEDICARE
Number P00400544
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 401(K) PLAN 2022 463755923 2023-09-29 NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621340
Sponsor’s telephone number 8139993030
Plan sponsor’s address 2321 CRESTOVER LN, WESLEY CHAPEL, FL, 33544
NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 401(K) PLAN 2021 463755923 2022-10-31 NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621340
Sponsor’s telephone number 8139993030
Plan sponsor’s address 2321 CRESTOVER LN, WESLEY CHAPEL, FL, 33544
NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 401(K) PLAN 2020 463755923 2021-10-11 NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621340
Sponsor’s telephone number 8139993030
Plan sponsor’s address 2321 CRESTOVER LN, WESLEY CHAPEL, FL, 33544
NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 401(K) PLAN 2019 463755923 2020-10-07 NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621340
Sponsor’s telephone number 8139993030
Plan sponsor’s address 2014 ASHLEY OAKS CIRCLE, SUITE 101, WESLEY CHAPEL, FL, 33544
NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 401(K) PLAN 2018 463755923 2019-04-05 NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621340
Sponsor’s telephone number 8139993030
Plan sponsor’s address 2014 ASHLEY OAKS CIRCLE, SUITE 101, WESLEY CHAPEL, FL, 33544
NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 401(K) PLAN 2017 463755923 2018-10-15 NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621340
Sponsor’s telephone number 8139993030
Plan sponsor’s address 2014 ASHLEY OAKS CIRCLE, SUITE 101, WESLEY CHAPEL, FL, 33544
NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 401(K) PLAN 2016 463755923 2018-01-11 NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621340
Sponsor’s telephone number 8139993030
Plan sponsor’s address 2014 ASHLEY OAKS CIRCLE, SUITE 101, WESLEY CHAPEL, FL, 33544
NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 401(K) PLAN 2015 463755923 2016-10-17 NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621340
Sponsor’s telephone number 8139993030
Plan sponsor’s address 2014 ASHLEY OAKS CIRCLE, SUITE 101, WESLEY CHAPEL, FL, 33544

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing STEPHEN EVERS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
De La Torre Jose Agent 2321 Crestover Lane, WESLEY CHAPEL, FL, 33544

President

Name Role Address
DE LA TORRE JOSE M President 2321 CRESTOVER LANE, WESLEY CHAPEL, FL, 33544

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2024-09-27 No data No data
CHANGE OF PRINCIPAL ADDRESS 2020-01-21 2321 Crestover Lane, WESLEY CHAPEL, FL 33544 No data
CHANGE OF MAILING ADDRESS 2020-01-21 2321 Crestover Lane, WESLEY CHAPEL, FL 33544 No data
REGISTERED AGENT ADDRESS CHANGED 2020-01-21 2321 Crestover Lane, WESLEY CHAPEL, FL 33544 No data
REGISTERED AGENT NAME CHANGED 2016-05-31 De La Torre, Jose No data

Documents

Name Date
REINSTATEMENT 2025-01-21
ANNUAL REPORT 2023-03-07
ANNUAL REPORT 2022-04-11
AMENDED ANNUAL REPORT 2021-03-30
ANNUAL REPORT 2021-01-28
ANNUAL REPORT 2020-01-21
ANNUAL REPORT 2019-02-07
ANNUAL REPORT 2018-02-08
ANNUAL REPORT 2017-01-11
AMENDED ANNUAL REPORT 2016-05-31

Related by officers

DE LA TORRE JOSE M

DLT REAL ESTATE, LLC NEW TAMPA WELLNESS, INC. ALLIANCE SPORTS MEDICINE AND REHABILITATION, INC.

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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