Entity Name: | PAIN PLUS, INC |
Jurisdiction: | FLORIDA |
Filing Type: | Domestic Profit |
Status: | Active |
Date Filed: | 15 Apr 2019 (6 years ago) |
Document Number: | P19000033861 |
FEI/EIN Number | 83-4594332 |
Address: | 1600 S Andrews Ave, Suite 723, Fort Lauderdale, FL, 33316, US |
Mail Address: | 17710 SW 63rd Manor, Southwest Ranches, FL, 33331, US |
ZIP code: | 33316 |
County: | Broward |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1427615335 | 2019-05-26 | 2019-08-23 | 453 SW 169TH TER, WESTON, FL, 333261530, US | 6816 GRIFFIN RD, DAVIE, FL, 333144341, US | |||||||||||||||||||
|
Phone | +1 954-300-7688 |
Phone | +1 954-900-3163 |
Authorized person
Name | DR. IAN KOWALSKI |
Role | OWNER |
Phone | 9543007688 |
Taxonomy
Taxonomy Code | 207RH0002X - Hospice and Palliative Medicine (Internal Medicine) Physician |
Is Primary | Yes |
Taxonomy Code | 208VP0000X - Pain Medicine Physician |
Is Primary | No |
Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
PAIN PLUS, INC. CASH BALANCE PLAN | 2023 | 834594332 | 2024-07-31 | PAIN PLUS, INC. | 2 | |||||||||||||||||||||||
|
Role | Plan administrator |
Date | 2024-07-31 |
Name of individual signing | IAN KOWALSKI |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2022-01-01 |
Business code | 621111 |
Sponsor’s telephone number | 9549003163 |
Plan sponsor’s address | 6816 GRIFFIN RD., DAVIE, FL, 33314 |
Signature of
Role | Plan administrator |
Date | 2024-08-13 |
Name of individual signing | IAN KOWALSKI |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2022-01-01 |
Business code | 621111 |
Sponsor’s telephone number | 9549003163 |
Plan sponsor’s address | 6816 GRIFFIN RD., DAVIE, FL, 33314 |
Signature of
Role | Plan administrator |
Date | 2023-09-13 |
Name of individual signing | IAN KOWALSKI |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 002 |
Effective date of plan | 2022-01-01 |
Business code | 621111 |
Sponsor’s telephone number | 9549003163 |
Plan sponsor’s address | 6816 GRIFFIN RD, DAVIE, FL, 33314 |
Signature of
Role | Plan administrator |
Date | 2023-08-16 |
Name of individual signing | IAN KOWALSKI |
Valid signature | Filed with authorized/valid electronic signature |
Name | Role | Address |
---|---|---|
Ian Kowalski JDO | Agent | 17710 SW 63rd Manor, Southwest Ranches, FL, 33331 |
Name | Role | Address |
---|---|---|
KOWALSKI IAN J | President | 17710 SW 63rd Manor, Southwest Ranches, FL, 33331 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
CHANGE OF PRINCIPAL ADDRESS | 2024-03-06 | 1600 S Andrews Ave, Suite 723, Fort Lauderdale, FL 33316 | No data |
CHANGE OF MAILING ADDRESS | 2022-01-31 | 1600 S Andrews Ave, Suite 723, Fort Lauderdale, FL 33316 | No data |
REGISTERED AGENT ADDRESS CHANGED | 2022-01-31 | 17710 SW 63rd Manor, Southwest Ranches, FL 33331 | No data |
REGISTERED AGENT NAME CHANGED | 2020-01-21 | Ian, Kowalski J, DO | No data |
Name | Date |
---|---|
ANNUAL REPORT | 2024-03-06 |
ANNUAL REPORT | 2023-02-16 |
ANNUAL REPORT | 2022-01-31 |
ANNUAL REPORT | 2021-01-12 |
ANNUAL REPORT | 2020-01-21 |
Domestic Profit | 2019-04-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State