| Entity Name: | JUPITER PAIN MANAGEMENT CONSULTANTS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Oct 1999 (25 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | P99000089881 |
| FEI/EIN Number | 650957718 |
| Address: | 2055 N MILITARY TR, JUPITER, FL, 33468 |
| Mail Address: | 2055 N MILITARY TR, JUPITER, FL, 33468, US |
| ZIP code: | 33468 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295002863 | 2011-11-25 | 2011-11-25 | 75 RIVER DR, TEQUESTA, FL, 334691950, US | 2151 S ALTERNATE A1A, SUITE 950, JUPITER, FL, 334774112, US | |||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||
| Phone | +1 561-743-2239 |
Authorized person
| Name | DR. NATHANIEL DROURR |
| Role | PRESIDENT |
| Phone | 5612625137 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| License Number | ME72880 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 047364200 |
| State | FL |
| Issuer | MEDICAID |
| Number | 253301400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DROURR NATHANIEL | Agent | 2055 N MILITARY TR, JUPITER, FL, 33468 |
| Name | Role | Address |
|---|---|---|
| DEZIEL LAWRENCE P | President | P.O. BOX 2328, JUPITER, FL, 33468 |
| Name | Role | Address |
|---|---|---|
| DEZIEL LAWRENCE P | Director | P.O. BOX 2328, JUPITER, FL, 33468 |
| DROURR NATHANIEL | Director | 2055 N MILITARY TR, JUPITER, FL, 33468 |
| Name | Role | Address |
|---|---|---|
| DROURR NATHANIEL | Vice President | 2055 N MILITARY TR, JUPITER, FL, 33468 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2022-02-09 | 2055 N MILITARY TR, JUPITER, FL 33468 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-02-09 | 2055 N MILITARY TR, JUPITER, FL 33468 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-04-11 | 2055 N MILITARY TR, JUPITER, FL 33468 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-02-06 |
| ANNUAL REPORT | 2022-02-09 |
| ANNUAL REPORT | 2021-02-10 |
| ANNUAL REPORT | 2020-01-25 |
| ANNUAL REPORT | 2019-03-16 |
| ANNUAL REPORT | 2018-01-20 |
| ANNUAL REPORT | 2017-01-30 |
| ANNUAL REPORT | 2016-03-01 |
| ANNUAL REPORT | 2015-01-13 |
| ANNUAL REPORT | 2014-03-05 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
