| Entity Name: | CENTRAL IMAGING OPEN MRI, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 10 Apr 1995 (30 years ago) |
| Document Number: | P95000029397 |
| FEI/EIN Number | 593309499 |
| Address: | 7777 131st St N, Seminole, FL, 33776, US |
| Mail Address: | 7777 131st St N, Seminole, FL, 33776, US |
| ZIP code: | 33776 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881697407 | 2005-05-27 | 2023-01-19 | PO BOX 946609, ATLANTA, GA, 303946609, US | 6101 CENTRAL AVE, ST PETERSBURG, FL, 337108529, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 727-381-4674 |
| Fax | 7273411182 |
Authorized person
| Name | MR. MATTHEW A BROWN |
| Role | PRESIDENT/OWNER |
| Phone | 7273814674 |
Taxonomy
| Taxonomy Code | 261QR0200X - Radiology Clinic/Center |
| License Number | HCC3718 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 112484800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BROWN MATTHEW A | Agent | 6101 CENTRAL AVENUE, ST. PETERSBURG, FL, 33710 |
| Name | Role | Address |
|---|---|---|
| BROWN MATTHEW | President | 7777 131ST ST N, SEMINOLE, FL, 33776 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000010765 | CENTRAL IMAGING "HIGH FIELD" OPEN MRI | ACTIVE | 2016-01-22 | 2026-12-31 | No data | 6101 CENTRAL AVE, ST. PETERSBURG, FL, 33702 |
| G14000090544 | CENTRAL IMAGING HIGH FIELD MRI | EXPIRED | 2014-09-04 | 2024-12-31 | No data | 6101 CENTRAL AVE, ST. PETERSBURG, FL, 33710 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2012-10-23 | No data | No data |
| NAME CHANGE AMENDMENT | 2002-12-02 | CENTRAL IMAGING OPEN MRI, INC. | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
