| Entity Name: | SUNCOAST OPEN MRI, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Jul 1998 (27 years ago) |
| Document Number: | M98000000793 |
| FEI/EIN Number | 582377947 |
| Address: | 511 EAST 23 STREET, PANAMA CITY, FL, 32402, US |
| Mail Address: | 1504 HARDEMAN AVE, SUITE A, MACON, GA, 31201, US |
| ZIP code: | 32402 |
| County: | Bay |
| Place of Formation: | GEORGIA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134188824 | 2006-03-21 | 2007-11-28 | PO BOX 4003, MACON, GA, 31208, US | 511 E 23RD ST, PANAMA CITY, FL, 324055307, US | |||||||||||||||||||||||||
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| Phone | +1 478-755-9966 |
| Phone | +1 850-747-8822 |
Authorized person
| Name | PETER O HOLLIDAY III |
| Role | DIRECTOR |
| Phone | 4784742360 |
Taxonomy
| Taxonomy Code | 261QM1200X - Magnetic Resonance Imaging (MRI) Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QR0200X - Radiology Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS |
| Number | V2722 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MCDANIEL NAWAL B | Agent | 1301 Riverplace Blvd, Jacksonville, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| Holliday Peter O | Manager | 1504 Hardeman Ave, Macon, GA, 31201 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2017-07-06 | No data | No data |
| LC STMNT OF RA/RO CHG | 2017-01-20 | No data | No data |
| NAME CHANGE AMENDMENT | 2000-07-10 | SUNCOAST OPEN MRI, LLC | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
