| Entity Name: | WESTERN IMAGING, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Jun 2002 (23 years ago) |
| Date of dissolution: | 24 Sep 2010 (14 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2010 (14 years ago) |
| Document Number: | P02000065274 |
| FEI/EIN Number | 020618933 |
| Address: | 11101 S CROWN WAY, SUITE 1, WELLINGTON, FL, 33414 |
| Mail Address: | 11101 S CROWN WAY, SUITE 1, WELLINGTON, FL, 33414 |
| ZIP code: | 33414 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952353856 | 2006-05-17 | 2009-10-26 | 11101 S CROWN WAY, SUITE 1, WELLINGTON, FL, 334148792, US | 11101 S CROWN WAY, SUITE 1, WELLINGTON, FL, 334148792, US | |||||||||||||||||||||
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| Phone | +1 561-795-9150 |
| Fax | 5617987700 |
Authorized person
| Name | DR. JONATHAN S HUBER |
| Role | PRESIDENT |
| Phone | 5617959150 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 2647745-00 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CONROY KELLY A | Agent | 11101 S CROWN WAY, WELLINGTON, FL, 33414 |
| Name | Role | Address |
|---|---|---|
| HUBER JONATHAN S | President | 11101 S CROWN WAY SUTIE 1, WELLINGTON, FL, 33411 |
| Name | Role | Address |
|---|---|---|
| KIRCHNER THOMAS M | Secretary | 11101 S CROWN WAY SUITE 1, WELLINGTON, FL, 33414 |
| Name | Role | Address |
|---|---|---|
| KIRCHNER THOMAS M | Treasurer | 11101 S CROWN WAY SUITE 1, WELLINGTON, FL, 33414 |
| Name | Role | Address |
|---|---|---|
| BAUMEL ERIC M | Vice President | 11101 S CROWN WAY SUITE 1, WELLINGTON, FL, 33414 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-09-17 | 11101 S CROWN WAY, SUITE 1, WELLINGTON, FL 33414 | No data |
| CHANGE OF MAILING ADDRESS | 2009-09-17 | 11101 S CROWN WAY, SUITE 1, WELLINGTON, FL 33414 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-09-17 | 11101 S CROWN WAY, SUITE 1, WELLINGTON, FL 33414 | No data |
| REGISTERED AGENT NAME CHANGED | 2004-04-29 | CONROY, KELLY A | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2009-09-17 |
| ANNUAL REPORT | 2008-04-30 |
| ANNUAL REPORT | 2007-04-24 |
| ANNUAL REPORT | 2006-04-27 |
| ANNUAL REPORT | 2005-04-28 |
| ANNUAL REPORT | 2004-04-29 |
| ANNUAL REPORT | 2003-05-19 |
| Domestic Profit | 2002-06-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
