| Entity Name: | PRIME RADIOLOGY OF MOUNT DORA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 07 Jan 2015 (10 years ago) |
| Date of dissolution: | 06 Apr 2018 (7 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 06 Apr 2018 (7 years ago) |
| Document Number: | P15000001997 |
| FEI/EIN Number | 47-2839268 |
| Mail Address: | 18981 US HWY 441, STE. 350, #113, MOUNT DORA, FL, 32757, US |
| Address: | 6909 OLD HIGHWAY 441, SUITE 103, MOUNT DORA, FL, 32757, US |
| ZIP code: | 32757 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780078667 | 2015-03-27 | 2015-03-27 | 6909 OLD HIGHWAY 441 S, MOUNT DORA, FL, 327577039, US | 6909 OLD HIGHWAY 441 S, MOUNT DORA, FL, 327577039, US | |||||||||||||||||||
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| Phone | +1 321-732-8487 |
| Fax | 3213485777 |
Authorized person
| Name | THOMAS BROWN |
| Role | OWNER |
| Phone | 3217328487 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| License Number | ME62144 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BROWN THOMAS DMD | Agent | 13750 W COLONIAL DRIVE, WINTER GARDEN, FL, 34787 |
| Name | Role | Address |
|---|---|---|
| BROWN THOMAS DMD | President | 13750 W COLONIAL DRIVE, STE 350 #113, WINTER GARDEN, FL, 34787 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000031736 | PRIME RADIOLOGY | EXPIRED | 2015-03-27 | 2020-12-31 | No data | 13750 W COLONIAL DRIVE, STE 350 #113, WINTER GARDEN, FL, 34787 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-04-06 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2017-08-16 | 6909 OLD HIGHWAY 441, SUITE 103, MOUNT DORA, FL 32757 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-03-12 | 6909 OLD HIGHWAY 441, SUITE 103, MOUNT DORA, FL 32757 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-01-18 |
| ANNUAL REPORT | 2016-03-03 |
| Domestic Profit | 2015-01-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
