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  5. UNIVERSITY DIAGNOSTIC INSTITUTE, LTD.

UNIVERSITY DIAGNOSTIC INSTITUTE, LTD.

Company Details

Entity Name: UNIVERSITY DIAGNOSTIC INSTITUTE, LTD.
Jurisdiction: FLORIDA
Filing Type: Domestic Limited Partnership
Status: Active
Date Filed: 21 Jun 1983 (42 years ago)
Document Number: A14741
FEI/EIN Number 592469164
Address: 3301 USF ALUMNI DRIVE, TAMPA, FL, 33612
Mail Address: 3301 USF ALUMNI DRIVE, TAMPA, FL, 33612
ZIP code: 33612
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1326021346 2005-11-23 2007-09-27 3301 ALUMNI DR, TAMPA, FL, 336129413, US 3301 ALUMNI DR, TAMPA, FL, 336129413, US

Contacts
Phone +1 813-972-3351
Fax 9139716892

Authorized person
Name MS. PAMELA EDWARDS
Role DIRECTOR OF OPERATIONS
Phone 8139723351

Taxonomy
Taxonomy Code 2085R0202X - Diagnostic Radiology Physician
Is Primary No
Taxonomy Code 261QM1200X - Magnetic Resonance Imaging (MRI) Clinic/Center
Is Primary No
Taxonomy Code 261QR0200X - Radiology Clinic/Center
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 06060900
State FL
Issuer AMERIGROUP
Number 227379
State FL
Issuer BLUE CROSS BLUE SHIELD
Number V2338
State FL
Issuer AVMED
Number 081944
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. PROFIT SHARING AND 401(K) PLAN 2023 592469164 2024-02-13 UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-01-01
Business code 621510
Sponsor’s telephone number 8139728540
Plan sponsor’s address 3301 USF ALUMNI DRIVE, TAMPA, FL, 336129413

Signature of
Role Plan administrator
Date 2024-02-13
Name of individual signing DEXTER STALLWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-02-13
Name of individual signing DEXTER STALLWORTH
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. PROFIT SHARING AND 401(K) PLAN 2022 592469164 2023-09-26 UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-01-01
Business code 621510
Sponsor’s telephone number 8139728540
Plan sponsor’s address 3301 USF ALUMNI DRIVE, TAMPA, FL, 336129413

Signature of
Role Plan administrator
Date 2023-09-26
Name of individual signing DEXTER STALLWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-09-26
Name of individual signing DEXTER STALLWORTH
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. PROFIT SHARING AND 401(K) PLAN 2021 592469164 2022-06-08 UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-01-01
Business code 621510
Sponsor’s telephone number 8139728540
Plan sponsor’s address 3301 USF ALUMNI DRIVE, TAMPA, FL, 336129413

Signature of
Role Plan administrator
Date 2022-06-08
Name of individual signing DEXTER STALLWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-06-08
Name of individual signing DEXTER STALLWORTH
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. PROFIT SHARING AND 401(K) PLAN 2020 592469164 2021-05-27 UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-01-01
Business code 621510
Sponsor’s telephone number 8139728540
Plan sponsor’s address 3301 USF ALUMNI DRIVE, TAMPA, FL, 336129413

Signature of
Role Plan administrator
Date 2021-05-27
Name of individual signing DEXTER STALLWORTH
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. PROFIT SHARING AND 401(K) PLAN 2019 592469164 2020-04-24 UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-01-01
Business code 621510
Sponsor’s telephone number 8139728540
Plan sponsor’s address 3301 USF ALUMNI DRIVE, TAMPA, FL, 336129413

Signature of
Role Plan administrator
Date 2020-04-24
Name of individual signing DEXTER STALLWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-04-24
Name of individual signing DEXTER STALLWORTH
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. PROFIT SHARING AND 401(K) PLAN 2018 592469164 2019-04-12 UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-01-01
Business code 621510
Sponsor’s telephone number 8139728540
Plan sponsor’s address 3301 USF ALUMNI DRIVE, TAMPA, FL, 336129413

Signature of
Role Plan administrator
Date 2019-04-12
Name of individual signing DEXTER STALLWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-04-12
Name of individual signing PAMELA EDWARDS
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. PROFIT SHARING AND 401(K) PLAN 2017 592469164 2018-04-10 UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-01-01
Business code 621510
Sponsor’s telephone number 8139728540
Plan sponsor’s address 3301 USF ALUMNI DRIVE, TAMPA, FL, 336129413

Signature of
Role Plan administrator
Date 2018-04-10
Name of individual signing PAMELA EDWARDS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-04-10
Name of individual signing PAMELA EDWARDS
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. PROFIT SHARING AND 401(K) PLAN 2016 592469164 2017-04-24 UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-01-01
Business code 621510
Sponsor’s telephone number 8139728540
Plan sponsor’s address 3301 USF ALUMNI DRIVE, TAMPA, FL, 336129413

Signature of
Role Plan administrator
Date 2017-04-24
Name of individual signing PAMELA EDWARDS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-04-24
Name of individual signing PAMELA EDWARDS
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. PROFIT SHARING AND 401(K) PLAN 2015 592469164 2016-04-12 UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-01-01
Business code 621510
Sponsor’s telephone number 8139728540
Plan sponsor’s address 3301 USF ALUMNI DRIVE, TAMPA, FL, 336129413

Signature of
Role Plan administrator
Date 2016-04-12
Name of individual signing DEXTER STALLWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-04-12
Name of individual signing DEXTER STALLWORTH
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. PROFIT SHARING AND 401(K) PLAN 2014 592469164 2015-04-23 UNIVERSITY DIAGNOSTIC INSTITUTE, LTD. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1990-01-01
Business code 621510
Sponsor’s telephone number 8139728540
Plan sponsor’s address 3301 ALUMNI DR, TAMPA, FL, 336129413

Signature of
Role Plan administrator
Date 2015-04-23
Name of individual signing DEXTER STALLWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-04-23
Name of individual signing DEXTER STALLWORTH
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
C T CORPORATION SYSTEM Agent

General Partner

Name Role Address
NEURORADIOLOGY ASSOCIATES OF TAMPA, PA General Partner 3301 USF ALUMNI DRIVE, TAMPA, FL, 33612

Events

Event Type Filed Date Value Description
MERGER 2014-12-19 No data CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 500000147555
LP AMENDMENT 2011-01-13 No data No data
AMENDMENT 2002-02-01 No data No data
REINSTATEMENT 1994-05-17 No data No data
REVOKED FOR ANNUAL REPORT 1994-04-15 No data No data
REINSTATEMENT 1992-05-22 No data No data
REVOCATION 1992-05-08 No data No data
AMENDMENT 1989-11-07 No data No data
AMENDED AND RESTATED CERTIFICATE 1987-08-04 No data No data
AMENDMENT 1986-12-29 No data No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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