| Entity Name: | PANHANDLE DIAGNOSTICS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 16 Jun 2023 (2 years ago) |
| Document Number: | L23000291947 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 5736 GRIFFITH CEMETERY ROAD, BAKER, FL 32531 |
| Mail Address: | 5736 GRIFFITH CEMETERY ROAD, BAKER, FL 32531 |
| ZIP code: | 32531 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366203655 | 2024-01-23 | 2024-01-23 | 5736 GRIFFITH CEMETERY RD, BAKER, FL, 325318402, US | 502 S MAIN ST, CRESTVIEW, FL, 325364250, US | |||||||||||||
|
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| Phone | +1 850-401-2418 |
Authorized person
| Name | KELLEY BROOKE MOSS |
| Role | CEO |
| Phone | 8503980108 |
Taxonomy
| Taxonomy Code | 2471S1302X - Sonography Radiologic Technologist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MOSS, KELLEY B | Agent | 5736 GRIFFITH CEMETERY ROAD, BAKER, FL 32531 |
| Name | Role | Address |
|---|---|---|
| MOSS, KELLEY B | Chief Executive Officer | 5736 GRIFFITH CEMETERY ROAD, BAKER, FL 32531 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-26 |
| Florida Limited Liability | 2023-06-16 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
