| Entity Name: | ULTRACARE MOBILE DIAGNOSTIC IMAGING L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 19 Jun 2009 (16 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | L09000059973 |
| FEI/EIN Number | 270450522 |
| Address: | 4181 IONA STREET, TITUSVILLE, FL, 32796 |
| Mail Address: | 4181 IONA STREET, TITUSVILLE, FL, 32796 |
| ZIP code: | 32796 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346573839 | 2009-09-15 | 2009-11-18 | 4181 IONA ST, TITUSVILLE, FL, 327962222, US | 4181 IONA ST, TITUSVILLE, FL, 327962222, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 321-795-7396 |
| Fax | 3212254936 |
Authorized person
| Name | MS. DEBORAH Y. HAZELBAKER |
| Role | SOLE PROPRIETOR |
| Phone | 3217957396 |
Taxonomy
| Taxonomy Code | 2471S1302X - Sonography Radiologic Technologist |
| License Number | 57090 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 335V00000X - Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| License Number | 57090 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BUSINESS LICENSE # |
| Number | 885043603 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HAZELBAKER DEBORAH Y | Agent | 4181 IONA STREET, TITUSVILLE, FL, 32796 |
| Name | Role | Address |
|---|---|---|
| HAZELBAKER DEBORAH Y | Managing Member | 4181 IONA STREET, TITUSVILLE, FL, 32796 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2012-01-24 |
| ANNUAL REPORT | 2011-02-20 |
| ANNUAL REPORT | 2010-06-16 |
| Florida Limited Liability | 2009-06-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
