| Entity Name: | PALM BEACH PAIN MANAGEMENT SPECIALISTS INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 17 Jan 2024 (a year ago) |
| Document Number: | P24000004972 |
| Address: | 907 N FEDERAL HWY, BOYNTON BEACH, FL 33435 |
| Mail Address: | 907 N FEDERAL HWY, BOYNTON BEACH, FL 33435 |
| ZIP code: | 33435 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881453777 | 2024-03-14 | 2024-06-06 | 907 N FEDERAL HWY, BOYNTON BEACH, FL, 334353224, US | 907 N FEDERAL HWY, BOYNTON BEACH, FL, 334353224, US | |||||||||||||||||||
|
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| Phone | +1 561-292-3747 |
| Fax | 5612923730 |
Authorized person
| Name | MS. SHANNEN SEVERSEN |
| Role | PRESIDENT |
| Phone | 5612923747 |
Taxonomy
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 261QP3300X - Pain Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SHANNEN, SEVERSEN | Agent | 907 N FEDERAL HWY, BOYNTON BEACH, FL 33435 |
| Name | Role | Address |
|---|---|---|
| SEVERSEN, SHANNEN | President | 907 N FEDERAL HWY, BOYNTON BEACH, FL 33435 |
| Name | Date |
|---|---|
| Domestic Profit | 2024-01-17 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
