| Entity Name: | NEW LIFE IMAGING.INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 07 Jun 2000 (25 years ago) |
| Document Number: | P00000054577 |
| FEI/EIN Number | 651022222 |
| Address: | 735 S Colorado ave, Stuart, FL, 34994, US |
| Mail Address: | 18500 Mach One Drive, FT. PIERCE, FL, 34987, US |
| ZIP code: | 34994 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033299516 | 2006-10-17 | 2009-07-30 | 501 NW LAKE WHITNEY PLACE, SUITE #106, PORT ST LUCIE, FL, 349863443, US | 501 NW LAKE WHITNEY PLACE, SUITE #106, PORT ST LUCIE, FL, 349863443, US | |||||||||||||||||||||||||||
|
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| Phone | +1 772-785-8000 |
| Fax | 7727858150 |
Authorized person
| Name | MRS. SUSAN A BROWN |
| Role | OWNER/OPERATOR |
| Phone | 7727858000 |
Taxonomy
| Taxonomy Code | 261QR0208X - Mobile Radiology Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 510001100 |
| State | FL |
| Issuer | BLUE SHIELD |
| Number | V2026 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BROWN SUSAN | Agent | 18500 mach one drive, FT. PIERCE, FL, 34945 |
| Name | Role | Address |
|---|---|---|
| BROWN SUSAN | President | 18500 Mach one drive, FT. PIERCE, FL, 34945 |
| Name | Role | Address |
|---|---|---|
| BROWN SUSAN | Director | 18500 Mach one drive, FT. PIERCE, FL, 34945 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-01 | 735 S Colorado ave, Stuite 116, Stuart, FL 34994 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-01 | 18500 mach one drive, FT. PIERCE, FL 34945 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-08 | 735 S Colorado ave, Stuite 116, Stuart, FL 34994 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J16000279897 | TERMINATED | 1000000711727 | ST LUCIE | 2016-04-25 | 2036-04-28 | $ 300.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT PIERCE SERVICE CENTER, 337 N US HIGHWAY 1 STE 207-B, FORT PIERCE FL349504255 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| ANNUAL REPORT | 2023-03-20 |
| ANNUAL REPORT | 2022-03-08 |
| ANNUAL REPORT | 2021-03-14 |
| ANNUAL REPORT | 2020-04-18 |
| ANNUAL REPORT | 2019-04-18 |
| ANNUAL REPORT | 2018-03-09 |
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-03-08 |
| ANNUAL REPORT | 2015-04-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
