| Entity Name: | KETI MEDICAL CENTER & PAIN MANAGEMENT INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 25 Nov 1997 (27 years ago) |
| Document Number: | P97000100832 |
| FEI/EIN Number | 59-3478878 |
| Address: | 7105 Mariner Blvd, SPRING HILL, FL 34609 |
| Mail Address: | 7105 Mariner Blvd, SPRING HILL, FL 34609 |
| ZIP code: | 34609 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205979291 | 2007-02-15 | 2023-08-11 | 7105 MARINER BLVD, SPRING HILL, FL, 346091048, US | 7105 MARINER BLVD, SPRING HILL, FL, 346091048, US | |||||||||||||||
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| Phone | +1 352-596-1339 |
| Fax | 3525968772 |
Authorized person
| Name | SHYAM S SWAIN |
| Role | PRESIDENT |
| Phone | 3525961339 |
Taxonomy
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SWAIN, SHYAM | Agent | 17310 LADERA ESTATES BLVD, LUTZ, FL 33548 |
| Name | Role | Address |
|---|---|---|
| SWAIN, SHYAM | President | 17310 Ladera Estates Blvd, LUTZ, FL 33548 |
| Name | Role | Address |
|---|---|---|
| SWAIN, SHYAM | Secretary | 17310 Ladera Estates Blvd, LUTZ, FL 33548 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000032536 | KETI WELLNESS & MED SPA | ACTIVE | 2024-03-03 | 2029-12-31 | No data | 7105 MARINER BLVD, SUITE A, SPRING HILL, FL, 34609 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-04-07 | 7105 Mariner Blvd, SPRING HILL, FL 34609 | No data |
| CHANGE OF MAILING ADDRESS | 2017-04-07 | 7105 Mariner Blvd, SPRING HILL, FL 34609 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-07 | 17310 LADERA ESTATES BLVD, LUTZ, FL 33548 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-04-16 |
| ANNUAL REPORT | 2022-04-24 |
| ANNUAL REPORT | 2021-02-23 |
| ANNUAL REPORT | 2020-04-03 |
| ANNUAL REPORT | 2019-04-06 |
| ANNUAL REPORT | 2018-04-07 |
| ANNUAL REPORT | 2017-04-07 |
| ANNUAL REPORT | 2016-04-20 |
| ANNUAL REPORT | 2015-04-07 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1517708301 | 2021-01-17 | 0491 | PPS | 7105 Mariner Blvd, Spring Hill, FL, 34609-1048 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7135937001 | 2020-04-07 | 0491 | PPP | 7105 Mariner Blvd., SPRING HILL, FL, 34609-1048 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Feb 2025
Sources: Florida Department of State
