| Entity Name: | AFA PAIN SPECIALISTS, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 12 Feb 2015 (10 years ago) |
| Document Number: | P15000014290 |
| FEI/EIN Number | 47-3100164 |
| Address: | 728 BLANDING BLVD, SUITE # C, ORANGE PARK, FL, 32065, US |
| Mail Address: | 728 BLANDING BLVD, ORANGE PARK, FL, 32065, US |
| ZIP code: | 32065 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679964449 | 2015-02-13 | 2015-12-02 | PO BOX 65748, ORANGE PARK, FL, 320650013, US | 728 BLANDING BLVD, SUITE C, ORANGE PARK, FL, 320657728, US | |||||||||||||||||||||||||||
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| Phone | +1 904-639-6747 |
| Fax | 9046396769 |
Authorized person
| Name | SHARIQ LATIF |
| Role | PRESIDENT |
| Phone | 9046543918 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| License Number | ME113190 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| License Number | ME113190 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LATIF SHARIQ | Agent | 728 BLANDING BLVD - STE. C, ORANGE PARK, FL, 32065 |
| Name | Role | Address |
|---|---|---|
| LATIF SHARIQ | President | 728 BLANDING BLVD, ORANGE PARK, FL, 32065 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2016-03-16 | 728 BLANDING BLVD, SUITE # C, ORANGE PARK, FL 32065 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-07-27 | 728 BLANDING BLVD - STE. C, ORANGE PARK, FL 32065 | No data |
| CHANGE OF MAILING ADDRESS | 2015-07-22 | 728 BLANDING BLVD, SUITE # C, ORANGE PARK, FL 32065 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2022-04-25 |
| ANNUAL REPORT | 2021-04-19 |
| ANNUAL REPORT | 2020-04-29 |
| ANNUAL REPORT | 2019-03-25 |
| ANNUAL REPORT | 2018-04-23 |
| ANNUAL REPORT | 2017-02-13 |
| ANNUAL REPORT | 2016-03-16 |
| Reg. Agent Change | 2015-07-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
