| Entity Name: | NATIONAL P.E.T. SCAN BROWARD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
NATIONAL P.E.T. SCAN BROWARD, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 19 Sep 2000 (25 years ago) |
| Date of dissolution: | 22 Sep 2023 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (2 years ago) |
| Document Number: | L00000011311 |
| FEI/EIN Number |
593673855
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1201 West Peachtree Street, NW, One Atlantic Center, Atlanta, GA, 30309-3470, US |
| Mail Address: | 1201 West Peachtree Street, NW, One Atlantic Center, Atlanta, GA, 30309-3470, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1194728014 | 2005-05-24 | 2012-12-05 | 6622 SOUTHPOINT DR S, SUITE 360, JACKSONVILLE, FL, 322168014, US | 6290 N FEDERAL HWY, FT LAUDERDALE, FL, 333081917, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-358-8441 |
| Fax | 9043582288 |
| Phone | +1 954-332-3000 |
| Fax | 9543322671 |
Authorized person
| Name | MS. MARGIE FAYE AUSTIN |
| Role | ADMINISTRATIVE ASSISTANT |
| Phone | 9043588441 |
Taxonomy
| Taxonomy Code | 261QR0200X - Radiology Clinic/Center |
| License Number | HCC5688 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | WELLCARE |
| Number | 196704 |
| State | FL |
| Issuer | AETNA - HMO |
| Number | 2630670 |
| State | FL |
| Issuer | TRICARE |
| Number | 593688943 |
| State | FL |
| Issuer | MEDICARE RAILROAD RETIREM |
| Number | CK2451 |
| State | FL |
| Issuer | NEIGHBORHOOD |
| Number | 38830 |
| State | FL |
| Issuer | FOUNDATION |
| Number | 67826 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD FL |
| Number | V2274 |
| State | FL |
| Issuer | HUMANA |
| Number | 593688943 |
| State | FL |
| Issuer | VISTA |
| Number | SG011169 |
| State | FL |
| Issuer | CIGNA |
| Number | 6958176-001 |
| State | FL |
| Issuer | AETNA - PPO |
| Number | 7441285 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Sullivan Matthew J | President | 1201 West Peachtree Street, NW, Atlanta, GA, 303093470 |
| GIBBS THOMAS E E | Agent | SMITH, GAMBRELL & RUSSELL, JACKSONVILLE, FL, 32202 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2021-12-03 | 1201 West Peachtree Street, NW, One Atlantic Center, Suite 3250, Atlanta, GA 30309-3470 | - |
| CHANGE OF MAILING ADDRESS | 2021-12-03 | 1201 West Peachtree Street, NW, One Atlantic Center, Suite 3250, Atlanta, GA 30309-3470 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2014-02-27 | SMITH, GAMBRELL & RUSSELL, 50 NORTH LAURA STREET, SUITE 2600, JACKSONVILLE, FL 32202 | - |
| REGISTERED AGENT NAME CHANGED | 2003-03-21 | GIBBS, THOMAS E ESQ. | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-04-25 |
| AMENDED ANNUAL REPORT | 2021-12-03 |
| ANNUAL REPORT | 2021-03-09 |
| ANNUAL REPORT | 2020-05-26 |
| ANNUAL REPORT | 2019-03-04 |
| ANNUAL REPORT | 2018-01-26 |
| ANNUAL REPORT | 2017-01-06 |
| ANNUAL REPORT | 2016-03-30 |
| ANNUAL REPORT | 2015-03-10 |
| ANNUAL REPORT | 2014-02-27 |
Date of last update: 01 May 2025
Sources: Florida Department of State
