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  5. PHYSIATRY PAIN MANAGEMENT, P.A.

PHYSIATRY PAIN MANAGEMENT, P.A. - Florida Company Profile

Company Details

Entity Name: PHYSIATRY PAIN MANAGEMENT, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

PHYSIATRY PAIN MANAGEMENT, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.
Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 23 Aug 1999 (26 years ago)
Date of dissolution: 27 Sep 2013 (12 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 27 Sep 2013 (12 years ago)
Document Number: P99000074946
FEI/EIN Number 593591941

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 907 MAR WALT DRIVE, SUITE 2013, FT WALTON BEACH, FL, 32547
Mail Address: 907 MAR WALT DRIVE, SUITE 2013, FT WALTON BEACH, FL, 32547
ZIP code: 32547
County: Okaloosa
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1720009046 2006-07-21 2020-08-22 999 MAR WALT DR, FORT WALTON BEACH, FL, 325476758, US 999 MAR WALT DR, FORT WALTON BEACH, FL, 325476758, US

Contacts
Phone +1 850-862-2912
Fax 8508622951

Authorized person
Name DR. FRANK C ZONDLO SR.
Role PRESIDENT
Phone 8508622912

Taxonomy
Taxonomy Code 174400000X - Specialist
License Number ME72558
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PHYSIATRY PAIN MANAGEMENT, P.A. 401(K) PROFIT SHARING PLAN 2012 593591941 2013-06-20 PHYSIATRY PAIN MANAGEMENT, P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8508622912
Plan sponsor’s address 907 MAR WALT DRIVE, SUITE 2013, FORT WALTON BEACH, FL, 32547

Signature of
Role Plan administrator
Date 2013-06-20
Name of individual signing FRANK ZONDLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-20
Name of individual signing FRANK ZONDLO
Valid signature Filed with authorized/valid electronic signature
PHYSIATRY PAIN MANAGEMENT, P.A. 401(K) PROFIT SHARING PLAN 2011 593591941 2012-08-27 PHYSIATRY PAIN MANAGEMENT, P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8508622912
Plan sponsor’s address 907 MAR WALT DRIVE, SUITE 2013, FORT WALTON BEACH, FL, 32547

Plan administrator’s name and address
Administrator’s EIN 593591941
Plan administrator’s name PHYSIATRY PAIN MANAGEMENT, P.A.
Plan administrator’s address 907 MAR WALT DRIVE, SUITE 2013, FORT WALTON BEACH, FL, 32547
Administrator’s telephone number 8508622912

Signature of
Role Plan administrator
Date 2012-08-27
Name of individual signing FRANK ZONDLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-08-27
Name of individual signing FRANK ZONDLO
Valid signature Filed with authorized/valid electronic signature
PHYSIATRY PAIN MANAGEMENT, P.A. 401(K) PROFIT SHARING PLAN 2010 593591941 2011-05-16 PHYSIATRY PAIN MANAGEMENT, P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8508622912
Plan sponsor’s address 907 MAR WALT DRIVE, SUITE 2013, FORT WALTON BEACH, FL, 32547

Plan administrator’s name and address
Administrator’s EIN 593591941
Plan administrator’s name PHYSIATRY PAIN MANAGEMENT, P.A.
Plan administrator’s address 907 MAR WALT DRIVE, SUITE 2013, FORT WALTON BEACH, FL, 32547
Administrator’s telephone number 8508622912

Signature of
Role Plan administrator
Date 2011-05-16
Name of individual signing FRANK ZONDLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-05-16
Name of individual signing FRANK ZONDLO
Valid signature Filed with authorized/valid electronic signature
PHYSIATRY PAIN MANAGEMENT, P.A. 401(K) PROFIT SHARING PLAN 2009 593591941 2010-05-17 PHYSIATRY PAIN MANAGEMENT, P.A. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8508622912
Plan sponsor’s address 999 MAR WALT DRIVE, FORT WALTON BEACH, FL, 32547

Plan administrator’s name and address
Administrator’s EIN 593591941
Plan administrator’s name PHYSIATRY PAIN MANAGEMENT, P.A.
Plan administrator’s address 999 MAR WALT DRIVE, FORT WALTON BEACH, FL, 32547
Administrator’s telephone number 8508622912

Signature of
Role Plan administrator
Date 2010-05-17
Name of individual signing FRANK ZONDLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-05-17
Name of individual signing FRANK ZONDLO
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
ZONDLO FRANK M Director 400 KELLY PLANTATION DRIVE, #903, DESTIN, FL, 32541
PITELL LISA Y Agent 4565 COMMMERCIAL DRIVE, NICEVILLE, FL, 32578

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G08028900365 INTERVENTIONAL PAIN CENTER EXPIRED 2008-01-28 2013-12-31 - 999 MAR WALT DR, FORT WALTON BEACH, FL, 32547

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2013-09-27 - -
CHANGE OF PRINCIPAL ADDRESS 2011-02-18 907 MAR WALT DRIVE, SUITE 2013, FT WALTON BEACH, FL 32547 -
CHANGE OF MAILING ADDRESS 2011-02-18 907 MAR WALT DRIVE, SUITE 2013, FT WALTON BEACH, FL 32547 -
REGISTERED AGENT ADDRESS CHANGED 2009-01-06 4565 COMMMERCIAL DRIVE, #103, NICEVILLE, FL 32578 -
REGISTERED AGENT NAME CHANGED 2008-10-30 PITELL, LISA Y -
CANCEL ADM DISS/REV 2008-10-30 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2008-09-26 - -

Documents

Name Date
ANNUAL REPORT 2012-04-18
ANNUAL REPORT 2011-02-18
ANNUAL REPORT 2010-03-11
ANNUAL REPORT 2009-01-06
REINSTATEMENT 2008-10-30
ANNUAL REPORT 2007-05-04
ANNUAL REPORT 2006-05-05
ANNUAL REPORT 2005-01-10
ANNUAL REPORT 2004-01-09
ANNUAL REPORT 2003-01-08

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Companies related by address

No other companies in our directory share the same address as PHYSIATRY PAIN MANAGEMENT, P.A.

Date of last update: 02 Apr 2025

Sources: Florida Department of State

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