| Entity Name: | SAND LAKE IMAGING, LLLP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Limited Partnership |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 22 Aug 2003 (22 years ago) |
| Last Event: | LLLP Statement of Qualification |
| Event Date Filed: | 22 Aug 2003 (22 years ago) |
| Document Number: | A03000001211 |
| FEI/EIN Number |
200186891
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 9350 Turkey Lake Road, Suite 100, Orlando, FL, 32819, US |
| Mail Address: | 5775 Wayzata Blvd., Suite 400, St Louis Park, MN, 55416, US |
| ZIP code: | 32819 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770565178 | 2005-11-19 | 2022-01-14 | PO BOX 161527, ALTAMONTE SPRINGS, FL, 327161527, US | 9350 TURKEY LAKE RD, ORLANDO, FL, 328197319, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 866-674-7933 |
| Phone | +1 407-363-2772 |
| Fax | 4077452844 |
Authorized person
| Name | SUSAN C HOLMAN |
| Role | SR. DIRECTOR, RCM |
| Phone | 8666747933 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BC BS OF FLORIDA |
| Number | V2904 |
| State | FL |
| Issuer | RAILROAD MEDICARE |
| Number | DD2395 |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000094217 | RAYUS | ACTIVE | 2021-07-19 | 2026-12-31 | - | 5775 WAYZATA BLVD.,, SUITE 400, ST. LOUIS PARK, MN, 55416 |
| G21000094223 | RAYUS RADIOLOGY | ACTIVE | 2021-07-19 | 2026-12-31 | - | 5775 WAYZATA BLVD.,, SUITE 400, ST. LOUIS PARK, MN, 55416 |
| G19000134506 | CLINICAL RESEARCH RADIOLOGY COLLABORATIVE SPECIALISTS | EXPIRED | 2019-12-19 | 2024-12-31 | - | P.O. BOX 690909, ORLANDO, FL, 32869 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-30 | 9350 Turkey Lake Road, Suite 100, Orlando, FL 32819 | - |
| REGISTERED AGENT NAME CHANGED | 2021-11-18 | CORPORATION SERVICE COMPANY | - |
| REGISTERED AGENT ADDRESS CHANGED | 2021-11-18 | 1201 HAYS STREET, TALLAHASSEE, FL 32301 | - |
| CHANGE OF MAILING ADDRESS | 2021-07-13 | 9350 Turkey Lake Road, Suite 100, Orlando, FL 32819 | - |
| LLLP Statement of Qualification | 2003-08-22 | SAND LAKE IMAGING, LLLP | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-02 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-01-24 |
| Reg. Agent Change | 2021-11-18 |
| ANNUAL REPORT | 2021-01-31 |
| ANNUAL REPORT | 2020-01-13 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-02-05 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-01-25 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
