| Entity Name: | CONCEPT IMAGING, LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 02 Sep 2011 (13 years ago) |
| Last Event: | LC AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 13 Aug 2012 (12 years ago) |
| Document Number: | L11000100859 |
| FEI/EIN Number | 453199613 |
| Address: | 1950 W Hillsboro Blvd, Deerfield Beach, FL, 33442, US |
| Mail Address: | P.O. BOX 4189, Deerfield Beach, FL, 33442, US |
| ZIP code: | 33442 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306389317 | 2016-11-22 | 2021-07-23 | 3889 MILITARY TRL STE 105, JUPITER, FL, 334582923, US | 3889 MILITARY TRL, SUITE 101, JUPITER, FL, 334582923, US | |||||||||||||||||||||
|
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| Phone | +1 567-932-0995 |
Authorized person
| Name | MAZIN SHIKARA |
| Role | PRESIDENT |
| Phone | 5617791652 |
Taxonomy
| Taxonomy Code | 261QR0200X - Radiology Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QR0208X - Mobile Radiology Clinic/Center |
| License Number | ME94252 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SHIKARA MAZIN M | Agent | 1950 W Hillsboro Blvd, Deerfield Beach, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| SHIKARA MAZIN M | Manager | 1950 W Hillsboro Blvd, Deerfield Beach, FL, 33442 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-21 | 1950 W Hillsboro Blvd, Suite 201, Deerfield Beach, FL 33442 | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-21 | 1950 W Hillsboro Blvd, Suite 201, Deerfield Beach, FL 33442 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-21 | 1950 W Hillsboro Blvd, Suite 201, Deerfield Beach, FL 33442 | No data |
| LC AMENDMENT AND NAME CHANGE | 2012-08-13 | CONCEPT IMAGING, LLC. | No data |
| REGISTERED AGENT NAME CHANGED | 2012-08-13 | SHIKARA, MAZIN MD | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-04-13 |
| ANNUAL REPORT | 2022-01-21 |
| ANNUAL REPORT | 2021-03-12 |
| ANNUAL REPORT | 2020-06-22 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-07 |
| ANNUAL REPORT | 2017-04-23 |
| ANNUAL REPORT | 2016-04-30 |
| ANNUAL REPORT | 2015-05-01 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
