| Entity Name: | FLORIDA DIAGNOSTIC IMAGING, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
FLORIDA DIAGNOSTIC IMAGING, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| 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: | 11 Jun 1984 (41 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 21 Aug 2019 (6 years ago) |
| Document Number: | H07598 |
| FEI/EIN Number |
592413179
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 5201 N.E. BABCOCK STREET, SUITE 5, PALM BAY, FL, 32905, US |
| Mail Address: | 5201 N.E. BABCOCK STREET, SUITE 5, PALM BAY, FL, 32905, US |
| ZIP code: | 32905 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | FLORIDA DIAGNOSTIC IMAGING, INC., IDAHO | 385056 | IDAHO |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1356305767 | 2006-04-13 | 2007-12-13 | 5201 BABCOCK ST NE, SUITE 5, PALM BAY, FL, 329054637, US | 5201 BABCOCK ST NE, SUITE 5, PALM BAY, FL, 329054637, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 321-676-5323 |
| Fax | 3219519253 |
Authorized person
| Name | DR. IAN LANDIS |
| Role | PRESIDENT |
| Phone | 3216765323 |
Taxonomy
| Taxonomy Code | 261QR0200X - Radiology Clinic/Center |
| License Number | HCC5282 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AVMED |
| Number | 102370 |
| State | FL |
| Issuer | FLORIDIANCARE |
| Number | 40016 |
| State | FL |
| Issuer | EMBRACED PROGRAM |
| Number | FDA 155978 |
| State | FL |
| Issuer | BCBS OF FLORIDA |
| Number | V2489 |
| State | FL |
| Issuer | FIRST HEALTH/MAIL HANDLER |
| Number | 1209448 |
| State | FL |
| Issuer | UNITEDHEALTHCARE MEDIPASS |
| Number | 16-00554 |
| State | FL |
| Issuer | STAYWELL/WELLCARE |
| Number | 17030 |
| State | FL |
| Issuer | AMERIGROUP |
| Number | 288660 |
| State | FL |
| Issuer | UNITED HEALTHCARE |
| Number | 1488395 |
| State | FL |
| Issuer | HEALTHEASE |
| Number | 17030 |
| State | FL |
| Issuer | WORKERS COMPENSATION |
| Number | OS0004065 |
| State | FL |
| Issuer | CIGNA |
| Number | 0782103 |
| State | FL |
| Issuer | AETNA |
| Number | 8208068 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| COTTI, BRUCE DAVID | Director | 1160 HOLLOW BROOK LANE, MALABAR, FL, 32950 |
| COTTI, BRUCE DAVID | Vice President | 1160 HOLLOW BROOK LANE, MALABAR, FL, 32950 |
| COTTI, BRUCE DAVID | President | 1160 HOLLOW BROOK LANE, MALABAR, FL, 32950 |
| COTTI, BRUCE DAVID | Treasurer | 1160 HOLLOW BROOK LANE, MALABAR, FL, 32950 |
| LANDIS, IAN | Director | 4223 STRICKLAND WAY, VERO BEACH, FL, 32967 |
| LANDIS, IAN | President | 4223 STRICKLAND WAY, VERO BEACH, FL, 32967 |
| LANDIS, IAN | Secretary | 4223 STRICKLAND WAY, VERO BEACH, FL, 32967 |
| J. PATRICK ANDERSON, ESQ. | Agent | 2200 FRONT STREET, MELBOURNE, FL, 32901 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2020-05-20 | 2200 FRONT STREET, 301, MELBOURNE, FL 32901 | - |
| AMENDMENT | 2019-08-21 | - | - |
| CHANGE OF MAILING ADDRESS | 2012-02-07 | 5201 N.E. BABCOCK STREET, SUITE 5, PALM BAY, FL 32905 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2007-01-24 | 5201 N.E. BABCOCK STREET, SUITE 5, PALM BAY, FL 32905 | - |
| REGISTERED AGENT NAME CHANGED | 2006-08-29 | J. PATRICK ANDERSON, ESQ. | - |
| CANCEL ADM DISS/REV | 2005-09-23 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | - | - |
| AMENDMENT | 1987-10-06 | - | - |
| AMENDMENT | 1987-03-23 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-01-16 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-05-20 |
| Amendment | 2019-08-21 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-01-11 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-01-25 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5386147300 | 2020-04-30 | 0455 | PPP | 5201 BABCOCK STREET NE SUITE 5, Palm Bay, FL, 32905 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Apr 2025
Sources: Florida Department of State
