| Entity Name: | MOBILE X-RAY SPECIALISTS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 29 Jan 1986 (39 years ago) |
| Document Number: | H96579 |
| FEI/EIN Number | 47-5208627 |
| Address: | 620 Maitland Avenue, Altamonte Springs, FL, 32701, US |
| Mail Address: | P.O. BOX 521292, LONGWOOD, FL, 32752, US |
| ZIP code: | 32701 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639607575 | 2017-05-23 | 2017-05-23 | PO BOX 521292, LONGWOOD, FL, 327521292, US | 6706 N 9TH AVE, PENSACOLA, FL, 325049303, US | |||||||||||||||||||||||
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| Phone | +1 877-887-3829 |
| Fax | 8884050653 |
Authorized person
| Name | MR. KEVIN PATRICK MCDONOUGH |
| Role | CEO |
| Phone | 8778873829 |
Taxonomy
| Taxonomy Code | 335V00000X - Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 0303071-00 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FENDER MICHAEL ESQ. | Agent | 620 MAITLAND AVENUE, ALTAMONTE SPRINGS, FL, 32701 |
| Name | Role | Address |
|---|---|---|
| McDonough Kevin | President | P.O. BOX 521292, LONGWOOD, FL, 32752 |
| Name | Role | Address |
|---|---|---|
| McDonough Kevin | Director | P.O. BOX 521292, LONGWOOD, FL, 32752 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REINSTATEMENT | 2011-01-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| REINSTATEMENT | 2002-03-18 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2001-09-21 | No data | No data |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
