| Entity Name: | RADIOLOGY PHYSICIANS OF INDIAN RIVER COUNTY , LC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 20 May 2003 (22 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L03000018204 |
| FEI/EIN Number | 61-1451374 |
| Address: | 3725 11TH CIRCLE, VERO BEACH, FL 32960 |
| Mail Address: | 3725 11TH CIRCLE, VERO BEACH, FL 32960 |
| ZIP code: | 32960 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982605291 | 2005-08-09 | 2010-01-13 | 3725 11TH CIRCLE, VERO BEACH, FL, 329604804, US | 3725 11TH CIRCLE, VERO BEACH, FL, 329604804, US | |||||||||||||||||||||||||||
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| Phone | +1 772-562-0163 |
| Fax | 7725675631 |
Authorized person
| Name | MRS. DONNA H DION |
| Role | BUSINESS MANAGER |
| Phone | 7724100155 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 038000800 |
| State | FL |
| Issuer | BLUE CROSS/BLUE SHIELD |
| Number | K4539 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NAGEL, HEATHER S, Dr. | Agent | 3725 11TH CIRCLE, VERO BEACH, FL 32960 |
| Name | Role | Address |
|---|---|---|
| JOYCE, PETER HMD | Managing Member | 3725 11TH CIRCLE, VERO BEACH, FL 32960 |
| NAGEL, HEATHER S | Managing Member | 3725 11TH CIRCLE, VERO BEACH, FL 32960 |
| PUSKAR, GEORGE TM.D. | Managing Member | 3725 11TH CIRCLE, VERO BEACH, FL 32960 |
| WEEKS, MARGARET WMD | Managing Member | 3725 11TH CIRCLE, VERO BEACH, FL 32960 |
| HOLMES, JOHN J | Managing Member | 3725 11TH CIRCLE, VERO BEACH, FL 32960 |
| KEDEM, CAROLINE | Managing Member | 3725 11TH CIRCLE, VERO BEACH, FL 32960 |
| YATES, CLARENCE B | Managing Member | 3725 11TH CIRCLE, VERO BEACH, FL 32960 |
| SACKS, JEFFREY B | Managing Member | 3725 11TH CIRCLE, VERO BEACH, FL 32960 |
| Armstead, Adam M | Managing Member | 3725 11TH CIRCLE, VERO BEACH, FL 32960 |
| Glazer, Jonathan K | Managing Member | 3725 11TH CIRCLE, VERO BEACH, FL 32960 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| LC REVOCATION OF DISSOLUTION | 2023-05-15 | No data | No data |
| LC VOLUNTARY DISSOLUTION | 2023-02-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-02-08 | NAGEL, HEATHER S, Dr. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-07-03 | 3725 11TH CIRCLE, VERO BEACH, FL 32960 | No data |
| CHANGE OF MAILING ADDRESS | 2007-07-03 | 3725 11TH CIRCLE, VERO BEACH, FL 32960 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-07-03 | 3725 11TH CIRCLE, VERO BEACH, FL 32960 | No data |
| Name | Date |
|---|---|
| LC Revocation of Dissolution | 2023-05-15 |
| LC Voluntary Dissolution | 2023-02-28 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-02-08 |
| ANNUAL REPORT | 2020-01-28 |
| ANNUAL REPORT | 2019-02-14 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-04-14 |
| AMENDED ANNUAL REPORT | 2015-07-13 |
Date of last update: 30 Jan 2025
Sources: Florida Department of State
