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  5. DAVID C. NUNLEY RADIOLOGY, INC.

DAVID C. NUNLEY RADIOLOGY, INC.

Company Details

Entity Name: DAVID C. NUNLEY RADIOLOGY, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 03 Sep 2004 (20 years ago)
Date of dissolution: 23 Sep 2022 (2 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 23 Sep 2022 (2 years ago)
Document Number: P04000127131
FEI/EIN Number 201579238
Address: 134 MYSTIC LANE, JUPITER, FL, 33458, US
Mail Address: 134 MYSTIC LANE, JUPITER, FL, 33458, US
ZIP code: 33458
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1952583213 2007-11-28 2012-02-24 1680 S CENTRAL BLVD, SUITE 112, JUPITER, FL, 334587395, US 1680 S CENTRAL BLVD, SUITE 112, JUPITER, FL, 334587395, US

Contacts
Phone +1 561-748-1116
Fax 5617482997

Authorized person
Name DR. DAVID CHARLES NUNLEY
Role PRESIDENT
Phone 5617481116

Taxonomy
Taxonomy Code 174400000X - Specialist
License Number ME90263
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 272766800
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DAVID C. NUNLEY RADIOLOGY, INC. 401K PROFIT SHARING PLAN AND TRUST 2012 201579238 2013-07-23 DAVID C NUNLEY RADIOLOGY, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617481116
Plan sponsor’s address 1680 S CENTRAL BLVD. SUITE 112, JUPITER, FL, 33458

Signature of
Role Plan administrator
Date 2013-07-23
Name of individual signing DAVID NUNLEY
Valid signature Filed with authorized/valid electronic signature
DAVID C. NUNLEY RADIOLOGY, INC. 401K PROFIT SHARING PLAN & TRUST 2012 201579238 2013-08-08 DAVID C. NUNLEY RADIOLOGY, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617481116
Plan sponsor’s address 1680 S. CENTRAL BLVD., SUITE 112, JUPITER, FL, 33458

Signature of
Role Plan administrator
Date 2013-08-08
Name of individual signing DAVID NUNLEY
Valid signature Filed with authorized/valid electronic signature
DAVID C. NUNLEY RADIOLOGY, INC. 401K PROFIT SHARING PLAN AND TRUST 2011 201579238 2012-09-11 DAVID C NUNLEY RADIOLOGY, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617481116
Plan sponsor’s address 1680 S CENTRAL BLVD. SUITE 112, JUPITER, FL, 33458

Plan administrator’s name and address
Administrator’s EIN 201579238
Plan administrator’s name DAVID C NUNLEY RADIOLOGY, INC.
Plan administrator’s address 1680 S CENTRAL BLVD. SUITE 112, JUPITER, FL, 33458
Administrator’s telephone number 5617481116

Signature of
Role Plan administrator
Date 2012-09-11
Name of individual signing DAVID NUNLEY
Valid signature Filed with authorized/valid electronic signature
DAVID C. NUNLEY RADIOLOGY, INC. 401K PROFIT SHARING PLAN AND TRUST 2010 201579238 2011-08-02 DAVID C NUNLEY RADIOLOGY, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617481116
Plan sponsor’s address 1680 S CENTRAL BLVD. STE 112, JUPITER, FL, 33458

Plan administrator’s name and address
Administrator’s EIN 201579238
Plan administrator’s name DAVID C NUNLEY RADIOLOGY, INC.
Plan administrator’s address 1680 S CENTRAL BLVD. STE 112, JUPITER, FL, 33458
Administrator’s telephone number 5617481116

Signature of
Role Plan administrator
Date 2011-08-02
Name of individual signing DAVID NUNLEY
Valid signature Filed with authorized/valid electronic signature
DAVID C. NUNLEY RADIOLOGY, INC. 401K PROFIT SHARING PLAN AND TRUST 2010 201579238 2011-08-02 DAVID C NUNLEY RADIOLOGY, INC. 3
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617481116
Plan sponsor’s address 1680 S CENTRAL BLVD. STE 112, JUPITER, FL, 33458

Plan administrator’s name and address
Administrator’s EIN 201579238
Plan administrator’s name DAVID C NUNLEY RADIOLOGY, INC.
Plan administrator’s address 1680 S CENTRAL BLVD. STE 112, JUPITER, FL, 33458
Administrator’s telephone number 5617481116

Signature of
Role Plan administrator
Date 2011-08-02
Name of individual signing DAVID NUNLEY
Valid signature Filed with incorrect/unrecognized electronic signature
DAVID C. NUNLEY RADIOLOGY, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2009 201579238 2010-09-21 DAVID C NUNLEY RADIOLOGY, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617481116
Plan sponsor’s address 1680 S CENTRAL BLVD. STE 112, JUPITER, FL, 33458

Plan administrator’s name and address
Administrator’s EIN 201579238
Plan administrator’s name DAVID C NUNLEY RADIOLOGY, INC.
Plan administrator’s address 1680 S CENTRAL BLVD. STE 112, JUPITER, FL, 33458
Administrator’s telephone number 5617481116

Signature of
Role Plan administrator
Date 2010-09-21
Name of individual signing DAVID NUNLEY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
NUNLEY DAVID C Agent 134 MYSTIC LANE, JUPITER, FL, 33458

President

Name Role Address
NUNLEY DAVID C President 134 MYSTIC LANE, JUPITER, FL, 33458

Secretary

Name Role Address
NUNLEY DAVID C Secretary 134 MYSTIC LANE, JUPITER, FL, 33458

Treasurer

Name Role Address
NUNLEY GAY A Treasurer 134 MYSTIC LANE, JUPITER, FL, 33458

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2022-09-23 No data No data
CHANGE OF MAILING ADDRESS 2015-01-13 134 MYSTIC LANE, JUPITER, FL 33458 No data
REGISTERED AGENT NAME CHANGED 2015-01-13 NUNLEY, DAVID C. No data
REGISTERED AGENT ADDRESS CHANGED 2015-01-13 134 MYSTIC LANE, JUPITER, FL 33458 No data
CHANGE OF PRINCIPAL ADDRESS 2014-11-14 134 MYSTIC LANE, JUPITER, FL 33458 No data

Documents

Name Date
ANNUAL REPORT 2021-03-14
ANNUAL REPORT 2020-03-05
ANNUAL REPORT 2019-04-12
ANNUAL REPORT 2018-04-10
ANNUAL REPORT 2017-04-06
ANNUAL REPORT 2016-04-26
ANNUAL REPORT 2015-01-13
ANNUAL REPORT 2014-01-15
ANNUAL REPORT 2013-02-27
ANNUAL REPORT 2012-04-29

Related by officers

NUNLEY DAVID C

JUPITER VASCULAR CENTER, LLC SPACHTULA MUSIC GROUP, INC JUPITER VASCULAR INDUSTRIES, INC. PAIR A DOCS CHARTERS, INC.

NUNLEY GAY A

PAIR A DOCS CHARTERS, INC.

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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