| Entity Name: | MRI - SOUTH UMBERTON, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 14 Oct 1983 (41 years ago) |
| Document Number: | G65005 |
| FEI/EIN Number | 222499226 |
| Address: | 5317 FRUITVILLE ROAD, UNIT #73, SARASOTA, FL, 34232, US |
| Mail Address: | 5317 FRUITVILLE ROAD, UNIT #73, SARASOTA, FL, 34232, US |
| ZIP code: | 34232 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801889902 | 2005-08-24 | 2009-12-08 | 551 N CATTLEMEN RD, 202, SARASOTA, FL, 342326444, US | 6500 66TH ST, PINELLAS PARK, FL, 337815030, US | |||||||||||||||||||||||||||||
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| Phone | +1 941-926-6228 |
| Fax | 9413716719 |
| Phone | +1 727-548-6736 |
| Fax | 7275480947 |
Authorized person
| Name | BELINDA HOLMES |
| Role | MANAGER |
| Phone | 9413654617 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| License Number | HCC3688 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 061303701 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BADERTSCHER DOUGLAS P | Agent | 5317 FRUITVILLE ROAD, SARASOTA, FL, 34232 |
| Name | Role | Address |
|---|---|---|
| BADERTSCHER DOUGLAS P | CRO | 5317 FRUITVILLE ROAD UNIT #73, SARASOTA, FL, 34232 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J15000244257 | TERMINATED | 1000000657639 | LEON | 2015-02-09 | 2035-02-11 | $ 330.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, SARASOTA SERVICE CENTER, 1991 MAIN ST STE 240, SARASOTA FL342365940 |
| J13000148297 | ACTIVE | 1000000442671 | LEON | 2013-01-02 | 2033-01-16 | $ 960.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, SARASOTA SERVICE CENTER, 1991 MAIN ST STE 240, SARASOTA FL342365940 |
| J13000148305 | TERMINATED | 1000000442672 | PINELLAS | 2012-12-28 | 2023-01-16 | $ 5,168.47 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, SARASOTA SERVICE CENTER, 1991 MAIN ST STE 240, SARASOTA FL342365940 |
| J03000044463 | LAPSED | 0000486992 | 27940 01493 | 2003-01-13 | 2023-02-03 | $ 26,538.91 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE SECTION, 1379 BLOUNTSTOWN HWY, TALLAHASSEE FL323041033 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
