| Entity Name: | BROADER MRI OF PALM BEACH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 Apr 2023 (2 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 11 Sep 2023 (a year ago) |
| Document Number: | L23000186783 |
| FEI/EIN Number | 92-3541297 |
| Address: | 5405 OKEECHOBEE BLVD, WEST PALM BEACH, FL, 33417, US |
| Mail Address: | 5405 OKEECHOBEE BLVD, WEST PALM BEACH, FL, 33417, US |
| ZIP code: | 33417 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376224956 | 2023-07-27 | 2023-09-13 | 5405 OKEECHOBEE BLVD #100, WEST PALM BEACH, FL, 33417, US | 5405 OKEECHOBEE BLVD #100, WEST PALM BEACH, FL, 33417, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 561-766-0304 |
| Fax | 3057689164 |
Authorized person
| Name | MANUEL IRIBAR |
| Role | OWNER |
| Phone | 5617660304 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 2085B0100X - Body Imaging Physician |
| Is Primary | Yes |
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| Is Primary | No |
| Name | Role |
|---|---|
| REGISTERED AGENTS INC | Agent |
| Name | Role | Address |
|---|---|---|
| IRIBAR JORGE M | Manager | 11900 WEST DIXIE HIGHWAY, NORTH MIAMI, FL, 33161 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2023-09-11 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-09-08 | 5405 OKEECHOBEE BLVD, #101, WEST PALM BEACH, FL 33417 | No data |
| CHANGE OF MAILING ADDRESS | 2023-09-08 | 5405 OKEECHOBEE BLVD, #101, WEST PALM BEACH, FL 33417 | No data |
| LC STMNT OF RA/RO CHG | 2023-06-14 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-06-14 | REGISTERED AGENTS INC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-06-14 | 7901 4TH ST. N, STE. 300, ST. PETERSBURG, FL 33702 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-30 |
| LC Amendment | 2023-09-11 |
| CORLCRACHG | 2023-06-14 |
| Florida Limited Liability | 2023-04-14 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
