| Entity Name: | BEACHES OPEN MRI OF THE TREASURE COAST, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 Sep 2001 (23 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 22 Jan 2024 (a year ago) |
| Document Number: | L01000015142 |
| FEI/EIN Number | 651140493 |
| Address: | 8300 West Sunrise Boulevard, Plantation, FL, 33322, US |
| Mail Address: | 8300 West Sunrise Boulevard, Plantation, FL, 33322, US |
| ZIP code: | 33322 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053427005 | 2006-08-22 | 2011-11-04 | 1615 NW FEDERAL HWY, STUART, FL, 34994, US | 1615 NW FEDERAL HWY, STUART, FL, 34994, US | |||||||||||||||||||||||||||
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| Phone | +1 772-878-5858 |
| Fax | 7726922480 |
Authorized person
| Name | ANDREW T WALKER |
| Role | OFFICER |
| Phone | 7728785858 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | U2628 |
| State | FL |
| Issuer | MEDICAID |
| Number | 265438500 |
| State | FL |
| Name | Role |
|---|---|
| LEGALINC CORPORATE SERVICES INC. | Agent |
| Name | Role | Address |
|---|---|---|
| SPEED DARREN | Manager | 8300 West Sunrise Boulevard, PLANTATION, FL, 33322 |
| FIX THOMAS MD | Manager | 6 Cranes Nest Street, Stuart, FL, 34996 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G09000132273 | BEACHES MRI | EXPIRED | 2009-07-08 | 2014-12-31 | No data | 10377 S US HIGHWAY 1, SUITE 100, PORT ST. LUCIE, FL, 34952 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-10 | 8300 West Sunrise Boulevard, Plantation, FL 33322 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-10 | 8300 West Sunrise Boulevard, Plantation, FL 33322 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-10 | 476 RIVERSIDE AVE., JACKSONVILLE, FL 32202 | No data |
| LC AMENDMENT | 2024-01-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-12-19 | LEGALINC CORPORATE SERVICES INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-10 |
| LC Amendment | 2024-01-22 |
| Reg. Agent Change | 2023-12-19 |
| ANNUAL REPORT | 2023-03-17 |
| ANNUAL REPORT | 2022-03-08 |
| ANNUAL REPORT | 2021-03-05 |
| ANNUAL REPORT | 2020-06-03 |
| ANNUAL REPORT | 2019-03-06 |
| ANNUAL REPORT | 2018-04-17 |
| ANNUAL REPORT | 2017-03-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
