| Entity Name: | PALM BEACH RADIOLOGY INSTITUTE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 Aug 2005 (20 years ago) |
| Document Number: | L05000078415 |
| FEI/EIN Number | 204075175 |
| Address: | 733 U.S. HIGHWAY ONE, BUILDING 2B, NORTH PALM BEACH, FL, 33408, US |
| Mail Address: | 733 U.S. HIGHWAY ONE, BUILDING 2B, NORTH PALM BEACH, FL, 33408, US |
| ZIP code: | 33408 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760541064 | 2006-12-06 | 2020-08-22 | 1500 N DIXIE HWAY, WEST PALM BEACH, FL, 33401, US | 1500 N DIXIE HWAY, WEST PALM BEACH, FL, 33401, US | |||||||||||||||
|
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| Phone | +1 561-837-4834 |
| Fax | 5618372225 |
Authorized person
| Name | STEVEN SAPER |
| Role | PRACTICE MANAGER |
| Phone | 5618374834 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| JONES FOSTER SERVICE, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| FORMAN WALTER M | Manager | 733 US HIGHWAY 1, NORTH PALM BEACH, FL, 33408 |
| STICKLE ROBERT M | Manager | 733 US HIGHWAY 1, NORTH PALM BEACH, FL, 33408 |
| WASSERMAN HUNTER M | Manager | 733 US HIGHWAY 1, NORTH PALM BEACH, FL, 33408 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000026909 | PALM BEACH RADIOLOGY | EXPIRED | 2013-03-18 | 2018-12-31 | No data | 733 US HIGHWAY ONE BUILDING 2B, NORTH PALM BEACH, FL, 33408 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-02-20 | 733 U.S. HIGHWAY ONE, BUILDING 2B, NORTH PALM BEACH, FL 33408 | No data |
| CHANGE OF MAILING ADDRESS | 2017-02-20 | 733 U.S. HIGHWAY ONE, BUILDING 2B, NORTH PALM BEACH, FL 33408 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-10 |
| ANNUAL REPORT | 2023-04-13 |
| ANNUAL REPORT | 2022-02-08 |
| ANNUAL REPORT | 2021-03-29 |
| ANNUAL REPORT | 2020-02-19 |
| ANNUAL REPORT | 2019-03-04 |
| ANNUAL REPORT | 2018-03-02 |
| AMENDED ANNUAL REPORT | 2017-02-20 |
| ANNUAL REPORT | 2017-02-16 |
| ANNUAL REPORT | 2016-04-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
