| Entity Name: | ANGEL WILLIAMSON IMAGING CENTER, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 18 Apr 1984 (41 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 06 Dec 2001 (23 years ago) |
| Document Number: | G96697 |
| FEI/EIN Number | 59-2395218 |
| Address: | 2319 BAYOU BLVD, PENSACOLA, FL 32503 |
| Mail Address: | 2319 BAYOU BLVD, PENSACOLA, FL 32503 |
| ZIP code: | 32503 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710081013 | 2006-09-08 | 2008-06-16 | 5120 BAYOU BLVD, SUITE 9, PENSACOLA, FL, 32503, US | 5120 BAYOU BLVD, SUITE 9, PENSACOLA, FL, 32503, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 850-476-1161 |
| Fax | 8504761550 |
Authorized person
| Name | MR. MICHAEL J WILLIAMSON |
| Role | ADMINISTRATOR |
| Phone | 8504761161 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | CA2365 |
| State | FL |
| Issuer | BCBS FL |
| Number | V2944 |
| State | FL |
| Issuer | MEDICAID |
| Number | 373112000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WILLIAMSON, ANGEL Y. | Agent | 2319 BAYOU BLVD, PENSACOLA, FL 32503 |
| Name | Role | Address |
|---|---|---|
| WILLIAMSON, ANGEL YM.D. | President | 5120 BAYOU BLVD, STE 9, PENSACOLA, FL 32503 |
| Name | Role | Address |
|---|---|---|
| WILLIAMSON, ANGEL YM.D. | Director | 5120 BAYOU BLVD, STE 9, PENSACOLA, FL 32503 |
| Name | Role | Address |
|---|---|---|
| WILLIAMSON, ANGEL YM.D. | Treasurer | 5120 BAYOU BLVD, STE 9, PENSACOLA, FL 32503 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-27 | 2319 BAYOU BLVD, PENSACOLA, FL 32503 | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-27 | 2319 BAYOU BLVD, PENSACOLA, FL 32503 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-27 | 2319 BAYOU BLVD, PENSACOLA, FL 32503 | No data |
| NAME CHANGE AMENDMENT | 2001-12-06 | ANGEL WILLIAMSON IMAGING CENTER, P.A. | No data |
| REGISTERED AGENT NAME CHANGED | 1998-01-27 | WILLIAMSON, ANGEL Y. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-03-27 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-21 |
| ANNUAL REPORT | 2020-02-11 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-01-21 |
| ANNUAL REPORT | 2015-01-06 |
Date of last update: 04 Feb 2025
Sources: Florida Department of State
