| Entity Name: | SUGAR MILL DIAGNOSTIC IMAGING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 07 Feb 2007 (18 years ago) |
| Document Number: | L07000014009 |
| FEI/EIN Number | 300403141 |
| Address: | 8303 S SUNCOAST BLVD, HOMOSASSA, FL, 34446, US |
| Mail Address: | 8303 S. Suncoast Blvd, Homosassa, FL, 34446, US |
| ZIP code: | 34446 |
| County: | Citrus |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235313057 | 2007-12-28 | 2013-07-31 | 8303 S SUNCOAST BLVD, HOMOSASSA, FL, 344465028, US | 8303 S SUNCOAST BLVD, HOMOSASSA, FL, 344465028, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 352-628-9900 |
| Fax | 3526289700 |
Authorized person
| Name | DR. MICHAEL KEITH HERRON |
| Role | OWNER |
| Phone | 3527956909 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| License Number | N/A |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QR0200X - Radiology Clinic/Center |
| License Number | ME84779 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | V3279 |
| Issuer | MEDICAID |
| Number | 000097001 |
| State | FL |
| Issuer | RR MEDICARE |
| Number | DN9284 |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | V003E |
| Issuer | MEDICAID |
| Number | 000097000 |
| State | FL |
| Issuer | MEDICAID |
| Number | 002077400 |
| State | FL |
| Issuer | RR MEDICARE |
| Number | DN9284 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Jennings Julie | Agent | 2700 N Leeds Pt, Hernando, FL, 34442 |
| Name | Role | Address |
|---|---|---|
| Herron Michael | Manager | 8303 S SUNCOAST BLVD, HOMOSASSA, FL, 34446 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-07 | 2700 N Leeds Pt, Hernando, FL 34442 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-08-21 | Jennings, Julie | No data |
| CHANGE OF MAILING ADDRESS | 2021-05-21 | 8303 S SUNCOAST BLVD, HOMOSASSA, FL 34446 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-29 | 8303 S SUNCOAST BLVD, HOMOSASSA, FL 34446 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13001080093 | LAPSED | 2011-CA-004232 | CITRUS CIRCUIT COURT | 2013-05-14 | 2018-06-11 | $32,046.00 | ALLIANCE HEALTHCARE SERVICES, INC., (SEE IMAGE FOR ADDITIONAL CREDITORS), 100 BAYVIEW CIRCLE, STE. 400, NEWPORT BEACH, CA 92660 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-07 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-13 |
| AMENDED ANNUAL REPORT | 2021-08-21 |
| ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2020-04-29 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-28 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-10 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
