| Entity Name: | BREVARD HMA DIAGNOSTIC IMAGING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
BREVARD HMA DIAGNOSTIC IMAGING, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 23 Aug 2010 (15 years ago) |
| Date of dissolution: | 20 Oct 2023 (2 years ago) |
| Last Event: | LC VOLUNTARY DISSOLUTION |
| Event Date Filed: | 20 Oct 2023 (2 years ago) |
| Document Number: | L10000088458 |
| FEI/EIN Number |
273138738
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4000 Meridian Boulevard, Franklin, TN, 37067, US |
| Mail Address: | 4000 Meridian Boulevard, Franklin, TN, 37067, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912036781 | 2007-03-05 | 2011-09-20 | 7970 N WICKHAM RD, MELBOURNE, FL, 329408299, US | 7970 N WICKHAM RD, MELBOURNE, FL, 329408299, US | |||||||||||||||||||||||||
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| Phone | +1 321-255-7711 |
| Fax | 3212557734 |
Authorized person
| Name | MR. TIMOTHY PARRY |
| Role | SR VP AND GENERAL COUNSEL |
| Phone | 2395983131 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| License Number | HCC3598 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 051814000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Hammons Kevin J | Manager | 4000 Meridian Boulevard, Franklin, TN, 37067 |
| Pitt Justin D | Manager | 4000 Meridian Boulevard, Franklin, TN, 37067 |
| Cash W. B | Manager | 4000 Meridian Boulevard, Franklin, TN, 37067 |
| CORPORATION SERVICE COMPANY | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000090468 | SUNTREE DIAGNOSTIC CENTER AND MAMMOGRAPHY CLINIC | EXPIRED | 2010-10-04 | 2015-12-31 | - | 5811 PELICAN BAY BOULEVARD, SUITE 500, NAPLES, FL, 34108-2710 |
| G10000090469 | WUESTHOFF X-RAY AND LAB AT BAYTREE | EXPIRED | 2010-10-04 | 2015-12-31 | - | 5811 PELICAN BAY BOULEVARD, SUITE 500, NAPLES, FL, 34108-2710 |
| G10000090470 | WUESTHOFF X-RAY AND LAB | EXPIRED | 2010-10-04 | 2015-12-31 | - | 5811 PELICAN BAY BOULEVARD, SUITE 500, NAPLES, FL, 34108-2710 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC VOLUNTARY DISSOLUTION | 2023-10-20 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-25 | 4000 Meridian Boulevard, Franklin, TN 37067 | - |
| CHANGE OF MAILING ADDRESS | 2019-04-25 | 4000 Meridian Boulevard, Franklin, TN 37067 | - |
| LC STMNT OF RA/RO CHG | 2014-02-25 | - | - |
| REGISTERED AGENT NAME CHANGED | 2014-02-25 | CORPORATION SERVICE COMPANY | - |
| REGISTERED AGENT ADDRESS CHANGED | 2014-02-25 | 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 | - |
| Name | Date |
|---|---|
| LC Voluntary Dissolution | 2023-10-20 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-04-23 |
| ANNUAL REPORT | 2021-04-22 |
| ANNUAL REPORT | 2020-04-14 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-04-21 |
| ANNUAL REPORT | 2017-04-18 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-04-21 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
