| Entity Name: | CUSTOM RADIOLOGY SOLUTIONS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 30 Aug 2007 (17 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | L07000089254 |
| FEI/EIN Number | 26-0820623 |
| Address: | 13731 METROPOLIS AVE, FT MYERS, FL 33912 |
| Mail Address: | 13731 METROPOLIS AVE, FT MYERS, FL 33912 |
| ZIP code: | 33912 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073790291 | 2008-01-30 | 2011-09-26 | 13300-56 S. CLEVELAND AVE #305, PMB#239, FORT MYERS, FL, 33907, US | 13731 METROPOLIS AVE, FORT MYERS, FL, 33912, US | |||||||||||||||||||||||||
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| Phone | +1 239-333-2484 |
| Fax | 2393332483 |
Authorized person
| Name | CHAIM J MARGOLIN |
| Role | MD/OWNER |
| Phone | 2393332484 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| License Number | ME62306 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAL LICENSE |
| Number | ME62306 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KYLE, KEVIN A | Agent | 1380 ROYAL PALM SQUARE BLVD, FT MYERS, FL 33919 |
| Name | Role | Address |
|---|---|---|
| MARGOLIN, CHAIM J | Managing Member | 14631 SAFE LANDING CT, FORT MYERS, FL 33908 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2010-04-20 | 13731 METROPOLIS AVE, FT MYERS, FL 33912 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-03-19 | 13731 METROPOLIS AVE, FT MYERS, FL 33912 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-04-19 |
| ANNUAL REPORT | 2012-04-08 |
| ANNUAL REPORT | 2011-04-04 |
| ANNUAL REPORT | 2010-04-20 |
| ANNUAL REPORT | 2009-04-29 |
| ANNUAL REPORT | 2008-03-19 |
| Florida Limited Liability | 2007-08-30 |
Date of last update: 27 Jan 2025
Sources: Florida Department of State
