| Entity Name: | SOUTH MIAMI OPEN MRI LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 11 Dec 2018 (6 years ago) |
| Document Number: | L18000284736 |
| FEI/EIN Number | 83-2835267 |
| Address: | 88 NE 168 STREET, NORTH MIAMI BEACH, FL 33162 |
| Mail Address: | 88 NE 168 STREET, NORTH MIAMI BEACH, FL 33162 |
| ZIP code: | 33162 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205497260 | 2019-06-21 | 2019-06-21 | 6161 SUNSET DR STE A, SOUTH MIAMI, FL, 331435045, US | 6161 SUNSET DR STE A, SOUTH MIAMI, FL, 331435045, US | |||||||||||||||||||||
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| Phone | +1 305-665-4674 |
| Fax | 3056694674 |
Authorized person
| Name | ROLAND J GRASS |
| Role | MANAGER |
| Phone | 3056654674 |
Taxonomy
| Taxonomy Code | 261QM1200X - Magnetic Resonance Imaging (MRI) Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AHCA LICENSE |
| Number | HCC11829 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GRASS, ROLAND J | Agent | 15508 SW 31st LN, Miami, FL 33185 |
| Name | Role | Address |
|---|---|---|
| GRASS, ROLAND J | Manager | 15508 SW 31ST LN, MIAMI, FL 33185 |
| RIVERA, EDUARDO L | Manager | 14437 NW 83RD PATH, MIAMI LAKES, FL 33016 |
| FERNANDEZ, WALTER H | Manager | 8316 NW 144TH TERRACE, MIAMI LAKES, FL 33016 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-10-28 | 88 NE 168 STREET, NORTH MIAMI BEACH, FL 33162 | No data |
| CHANGE OF MAILING ADDRESS | 2024-10-28 | 88 NE 168 STREET, NORTH MIAMI BEACH, FL 33162 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-04-08 | GRASS, ROLAND J | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-08 | 15508 SW 31st LN, Miami, FL 33185 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-07-19 |
| ANNUAL REPORT | 2021-03-13 |
| ANNUAL REPORT | 2020-03-26 |
| ANNUAL REPORT | 2019-04-08 |
| Florida Limited Liability | 2018-12-11 |
Date of last update: 17 Jan 2025
Sources: Florida Department of State
