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  5. FLORIDA PAIN MEDICINE ASSOCIATES, INC.

FLORIDA PAIN MEDICINE ASSOCIATES, INC.

Company Details

Entity Name: FLORIDA PAIN MEDICINE ASSOCIATES, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 26 Jul 1999 (26 years ago)
Date of dissolution: 09 Sep 2016 (8 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 09 Sep 2016 (8 years ago)
Document Number: P99000065848
FEI/EIN Number 65-0936875
Address: 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL 33435
Mail Address: 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL 33435
ZIP code: 33435
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1598788903 2006-07-26 2014-04-04 2828 S SEACREST BLVD, SUITE 210, BOYNTON BEACH, FL, 334357944, US 2828 S SEACREST BLVD, SUITE 210, BOYNTON BEACH, FL, 334357944, US

Contacts
Phone +1 561-369-7644

Authorized person
Name DR. BART GERARD GATZ
Role PRESIDENT
Phone 5613697644

Taxonomy
Taxonomy Code 207LP2900X - Pain Medicine (Anesthesiology) Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FLORIDA PAIN MEDICINE ASSOCIATES, INC. PROFIT SHARING & 401(K) PLAN 2015 650936875 2016-09-07 FLORIDA PAIN MEDICINE ASSOCIATES, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5613697644
Plan sponsor’s address 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL, 33435
FLORIDA PAIN MEDICINE ASSOCIATES, INC. PROFIT SHARINGTRUST 2015 650936875 2016-09-07 FLORIDA PAIN MEDICINE ASSOCIATES, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5613697644
Plan sponsor’s address 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL, 33435
FLORIDA PAIN MEDICINE ASSOCIATES, INC. PROFIT SHARINGTRUST 2014 650936875 2015-10-02 FLORIDA PAIN MEDICINE ASSOCIATES, INC. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5613697644
Plan sponsor’s address 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL, 33435

Signature of
Role Plan administrator
Date 2015-10-02
Name of individual signing ALEXIS RENTA
Valid signature Filed with authorized/valid electronic signature
FLORIDA PAIN MEDICINE ASSOCIATES, INC. PROFIT SHARINGTRUST 2013 650936875 2014-06-03 FLORIDA PAIN MEDICINE ASSOCIATES, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5613697644
Plan sponsor’s address 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL, 33435

Plan administrator’s name and address
Administrator’s EIN 650936875
Plan administrator’s name FLORIDA PAIN MEDICINE ASSOCIATES, INC.
Plan administrator’s address 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL, 33435
Administrator’s telephone number 5613697644

Signature of
Role Plan administrator
Date 2014-06-03
Name of individual signing ALEXIS RENTA
Valid signature Filed with authorized/valid electronic signature
FLORIDA PAIN MEDICINE ASSOCIATES, INC. PROFIT SHARINGTRUST 2012 650936875 2013-10-10 FLORIDA PAIN MEDICINE ASSOCIATES, INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5613697644
Plan sponsor’s address 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL, 33435

Plan administrator’s name and address
Administrator’s EIN 650936875
Plan administrator’s name FLORIDA PAIN MEDICINE ASSOCIATES, INC.
Plan administrator’s address 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL, 33435
Administrator’s telephone number 5613697644

Signature of
Role Plan administrator
Date 2013-10-10
Name of individual signing ALEXIS RENTA
Valid signature Filed with authorized/valid electronic signature
FLORIDA PAIN MEDICINE ASSOCIATES, INC. PROFIT SHARINGTRUST 2011 650936875 2012-10-02 FLORIDA PAIN MEDICINE ASSOCIATES, INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5613697644
Plan sponsor’s address 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL, 33435

Plan administrator’s name and address
Administrator’s EIN 650936875
Plan administrator’s name FLORIDA PAIN MEDICINE ASSOCIATES, INC.
Plan administrator’s address 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL, 33435
Administrator’s telephone number 5613697644

Signature of
Role Plan administrator
Date 2012-10-02
Name of individual signing BART GATZ
Valid signature Filed with authorized/valid electronic signature
FLORIDA PAIN MEDICINE ASSOCIATES, INC. PROFIT SHARINGTRUST 2010 650936875 2011-09-30 FLORIDA PAIN MEDICINE ASSOCIATES, INC. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5613697644
Plan sponsor’s address 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL, 33435

Plan administrator’s name and address
Administrator’s EIN 650936875
Plan administrator’s name FLORIDA PAIN MEDICINE ASSOCIATES, INC.
Plan administrator’s address 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL, 33435
Administrator’s telephone number 5613697644

Signature of
Role Plan administrator
Date 2011-09-30
Name of individual signing BART GATZ
Valid signature Filed with authorized/valid electronic signature
FLORIDA PAIN MEDICINE ASSOCIATES, INC. PROFIT SHARINGTRUST 2009 650936875 2010-09-07 FLORIDA PAIN MEDICINE ASSOCIATES, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5613697644
Plan sponsor’s address 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL, 33435

Plan administrator’s name and address
Administrator’s EIN 650936875
Plan administrator’s name FLORIDA PAIN MEDICINE ASSOCIATES, INC.
Plan administrator’s address 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL, 33435
Administrator’s telephone number 5613697644

Signature of
Role Plan administrator
Date 2010-09-07
Name of individual signing BART GATZ
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
COHEN, JEFFREY LESQ. Agent 54 N.E. FOURTH AVENUE, DELRAY BEACH, FL 33483

Director

Name Role Address
RENTA, ALEXIS M.D. Director 2828 S. SEACREST BLVD., BOYNTON BEACH, FL 33435
RODRIGUEZ, ALBERT M.D. Director 2828 S. SEACREST BLVD., BOYNTON BEACH, FL 33435
GATZ, BART M.D. Director 2828 S. SEACREST BLVD., BOYNTON BEACH, FL 33435

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2016-09-09 No data No data
CHANGE OF MAILING ADDRESS 2007-09-25 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL 33435 No data
CANCEL ADM DISS/REV 2007-09-25 No data No data
CHANGE OF PRINCIPAL ADDRESS 2007-09-25 2828 S. SEACREST BLVD., SUITE 210, BOYNTON BEACH, FL 33435 No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2007-09-14 No data No data
AMENDMENT 1999-09-08 No data No data
AMENDMENT 1999-08-23 No data No data

Documents

Name Date
Voluntary Dissolution 2016-09-09
ANNUAL REPORT 2015-03-26
ANNUAL REPORT 2014-05-01
ANNUAL REPORT 2013-04-18
ANNUAL REPORT 2012-01-18
ANNUAL REPORT 2011-01-26
ANNUAL REPORT 2010-02-03
ANNUAL REPORT 2009-02-17
ANNUAL REPORT 2008-02-05
REINSTATEMENT 2007-09-25

Related by officers

COHEN, JEFFREY LESQ.

ATLANTIC SPINE OF SOUTH FLORIDA LLC OFFICE CONCEPTS & DESIGN, INC. WPT TECHNOLOGIES, LLC GREEN HUMMINGBIRD INVESTMENTS, LLC ZIP RX INC. OLYMPIA RADIOLOGY CENTER, LLC JJ & MS ENTERPRISES, INC. PODICARE MANAGEMENT SERVICES, L.C. BONES ACQUISITION, L.L.C.

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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