| Entity Name: | BEACHES OPEN MRI OF PBG LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Sep 2001 (23 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 01 Feb 2024 (a year ago) |
| Document Number: | L01000015194 |
| FEI/EIN Number | 651140494 |
| Address: | 8300 W. SUNRISE BLVD, PLANTATION, FL, 33322, US |
| Mail Address: | 8300 W. SUNRISE BLVD, PLANTATION, FL, 33322, US |
| ZIP code: | 33322 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881783553 | 2006-10-12 | 2020-08-22 | 2701 PGA BLVD, SUITE A, PALM BEACH GARDENS, FL, 33410, US | 2701 PGA BLVD, SUITE A, PALM BEACH GARDENS, FL, 33410, US | |||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 561-627-1111 |
| Fax | 5616276677 |
Authorized person
| Name | ANDREW T WALKER |
| Role | OFFICER |
| Phone | 7728785858 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| License Number | ME0058016 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| License Number | ME0070441 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| License Number | ME0061896 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS |
| Number | V2937 |
| State | FL |
| Name | Role |
|---|---|
| LEGALINC CORPORATE SERVICES INC. | Agent |
| Name | Role | Address |
|---|---|---|
| SPEED DARREN | Managing Member | 8300 W. SUNRISE BLVD, PLANTATION, FL, 33322 |
| Name | Role | Address |
|---|---|---|
| FIX THOMAS M.D. | Manager | 8300 W. SUNRISE BLVD, PLANTATION, FL, 33322 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G04125900263 | BEACHES MRI | EXPIRED | 2004-05-04 | 2024-12-31 | No data | 2701 PGA BLVD., SUITE A, PALM BEACH GARDENS, FL, 33410 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-01 | 8300 W. SUNRISE BLVD, PLANTATION, FL 33322 | No data |
| LC AMENDMENT | 2024-02-01 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-01 | 8300 W. SUNRISE BLVD, PLANTATION, FL 33322 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-05 | 476 RIVERSIDE AVE, JACKSONVILLE, FL 32202 | No data |
| LC STMNT OF RA/RO CHG | 2024-01-05 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-01-05 | LEGALINC CORPORATE SERVICES INC. | No data |
| NAME CHANGE AMENDMENT | 2003-08-01 | BEACHES OPEN MRI OF PBG LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-04 |
| LC Amendment | 2024-02-01 |
| CORLCRACHG | 2024-01-05 |
| 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: 02 Feb 2025
Sources: Florida Department of State
