| Entity Name: | CENTRAL FLORIDA IMAGING OF LEESBURG, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 29 Jun 2018 (7 years ago) |
| Date of dissolution: | 13 Dec 2019 (5 years ago) |
| Last Event: | CORPORATE MERGER |
| Event Date Filed: | 13 Dec 2019 (5 years ago) |
| Document Number: | L18000159956 |
| FEI/EIN Number | 83-1119722 |
| Address: | 106 W NORTH BLVD, STE 104, LEESBURG, FL, 34748, US |
| Mail Address: | 106 W NORTH BLVD, STE 104, LEESBURG, FL, 34748, US |
| ZIP code: | 34748 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982162681 | 2019-03-12 | 2019-08-12 | 425 ALEXANDRIA BLVD STE 1000, OVIEDO, FL, 327655548, US | 106 W NORTH BLVD STE 104, LEESBURG, FL, 347485039, US | |||||||||||||||
|
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| Phone | +1 407-977-3434 |
| Phone | +1 321-318-6758 |
Authorized person
| Name | MARC OTT |
| Role | CEO |
| Phone | 3527024275 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| KABA CONSULTING INC. | Agent |
| Name | Role | Address |
|---|---|---|
| INTEGRATIVE PHYSICAL MEDICINE HOLDING LLC | Manager | 425 ALEXANDRIA BLVD STE 1010, OVIEDO, FL, 32765 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000075921 | COMPLETE CARE | EXPIRED | 2019-07-12 | 2024-12-31 | No data | 106 W NORTH BLVD, STE 104, LEESBURG, FL, 34748 |
| G19000067347 | CENTERS FOR IMAGING | EXPIRED | 2019-06-13 | 2024-12-31 | No data | 106 W NORTH BLVD, STE 104, LEESBURG, FL, 34748 |
| G18000078640 | INTEGRATIVE PHYSICAL MEDICINE | EXPIRED | 2018-07-20 | 2023-12-31 | No data | 106 W NORTH BLVD, STE 102, LEESBURG, FL, 34748 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| MERGER | 2019-12-13 | No data | CORPORATION WAS PART OF A MERGER. QUALIFIED CORPORATION WAS L12000112955. MERGER NUMBER 100000198281 |
| CHANGE OF PRINCIPAL ADDRESS | 2019-08-20 | 106 W NORTH BLVD, STE 104, LEESBURG, FL 34748 | No data |
| CHANGE OF MAILING ADDRESS | 2019-08-20 | 106 W NORTH BLVD, STE 104, LEESBURG, FL 34748 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-18 |
| Florida Limited Liability | 2018-06-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
