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  5. MRI ASSOCIATES OF ST. PETE, INC.

MRI ASSOCIATES OF ST. PETE, INC.

Company Details

Entity Name: MRI ASSOCIATES OF ST. PETE, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 03 Dec 1997 (27 years ago)
Document Number: P97000102558
FEI/EIN Number 593483191
Address: 750 94TH AVE NORTH, #206, ST. PETERSBURG, FL, 33702
Mail Address: 750 94TH AVE NORTH, #206, ST. PETERSBURG, FL, 33702
ZIP code: 33702
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1972518405 2006-07-31 2008-09-22 750 94TH AVE N STE 206, ST PETERSBURG, FL, 337022453, US 750 94TH AVE N STE 206, ST PETERSBURG, FL, 337022453, US

Contacts
Phone +1 727-577-2220
Fax 7275786452

Authorized person
Name MS. KIMBERLY MAHONEY
Role OWNER
Phone 7275772220

Taxonomy
Taxonomy Code 261QR0200X - Radiology Clinic/Center
License Number HCC3960
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 276042800
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MRI ASSOCIATES OF ST. PETE, INC. 401(K) PROFIT SHARING PLAN 2023 593483191 2024-10-21 MRI ASSOCIATES OF ST. PETE, INC. 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621498
Sponsor’s telephone number 7275772220
Plan sponsor’s address 750 94TH AVE. NORTH, SUITE 206, ST. PETERSBURG, FL, 33702

Signature of
Role Plan administrator
Date 2024-10-21
Name of individual signing PEYTON LACY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-10-21
Name of individual signing PEYTON LACY
Valid signature Filed with authorized/valid electronic signature
MRI ASSOCIATES OF ST. PETE, INC. 401(K) PROFIT SHARING PLAN 2022 593483191 2023-10-13 MRI ASSOCIATES OF ST. PETE, INC. 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621498
Sponsor’s telephone number 7275772220
Plan sponsor’s address 750 94TH AVE. NORTH, SUITE 206, ST. PETERSBURG, FL, 33702

Signature of
Role Plan administrator
Date 2023-10-13
Name of individual signing PEYTON LACY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-13
Name of individual signing PEYTON LACY
Valid signature Filed with authorized/valid electronic signature
MRI ASSOCIATES OF ST. PETE, INC. 401(K) PROFIT SHARING PLAN 2021 593483191 2022-10-10 MRI ASSOCIATES OF ST. PETE, INC. 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621498
Sponsor’s telephone number 7275772220
Plan sponsor’s address 750 94TH AVE. NORTH, SUITE 206, ST. PETERSBURG, FL, 33702

Signature of
Role Plan administrator
Date 2022-10-10
Name of individual signing PEYTON LACY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-10
Name of individual signing PEYTON LACY
Valid signature Filed with authorized/valid electronic signature
MRI ASSOCIATES OF ST. PETE, INC. 401(K) PROFIT SHARING PLAN 2020 593483191 2021-10-11 MRI ASSOCIATES OF ST. PETE, INC. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621498
Sponsor’s telephone number 7275772220
Plan sponsor’s address 750 94TH AVE. NORTH, SUITE 206, ST. PETERSBURG, FL, 33702

Signature of
Role Plan administrator
Date 2021-10-11
Name of individual signing PEYTON LACY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-11
Name of individual signing PEYTON LACY
Valid signature Filed with authorized/valid electronic signature
MRI ASSOCIATES OF ST. PETE, INC. 401(K) PSP 2019 593483191 2020-10-07 MRI ASSOCIATES OF ST. PETE, INC. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621498
Sponsor’s telephone number 7275772220
Plan sponsor’s address 750 94TH AVE. NORTH, SUITE 206, ST. PETERSBURG, FL, 33702

Signature of
Role Plan administrator
Date 2020-10-07
Name of individual signing PEYTON LACY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-07
Name of individual signing PEYTON LACY
Valid signature Filed with authorized/valid electronic signature
MRI ASSOCIATES OF ST. PETE, INC. 401(K) PSP 2018 593483191 2019-10-04 MRI ASSOCIATES OF ST. PETE, INC. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621498
Sponsor’s telephone number 7275772220
Plan sponsor’s address 750 94TH AVE. NORTH, SUITE 206, ST. PETERSBURG, FL, 33702

Signature of
Role Plan administrator
Date 2019-10-04
Name of individual signing PEYTON LACY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-04
Name of individual signing PEYTON LACY
Valid signature Filed with authorized/valid electronic signature
MRI ASSOCIATES OF ST. PETE, INC. 401(K) PSP 2017 593483191 2018-10-04 MRI ASSOCIATES OF ST. PETE, INC. 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621498
Sponsor’s telephone number 7275772220
Plan sponsor’s address 750 94TH AVE. NORTH, SUITE 206, ST. PETERSBURG, FL, 33702

Signature of
Role Plan administrator
Date 2018-10-04
Name of individual signing PEYTON LACY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-04
Name of individual signing PEYTON LACY
Valid signature Filed with authorized/valid electronic signature
MRI ASSOCIATES OF ST. PETE, INC. 401(K) PSP 2016 593483191 2017-07-26 MRI ASSOCIATES OF ST. PETE, INC. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621498
Sponsor’s telephone number 7275772220
Plan sponsor’s address 750 94TH AVE. NORTH, SUITE 206, ST. PETERSBURG, FL, 33702

Signature of
Role Plan administrator
Date 2017-07-26
Name of individual signing PEYTON LACY
Valid signature Filed with authorized/valid electronic signature
MRI ASSOCIATES OF ST. PETE, INC. 401(K) PSP 2015 593483191 2016-09-20 MRI ASSOCIATES OF ST. PETE, INC. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621498
Sponsor’s telephone number 7275772220
Plan sponsor’s address 750 94TH AVE. NORTH, SUITE 206, ST. PETERSBURG, FL, 33702

Signature of
Role Plan administrator
Date 2016-09-20
Name of individual signing KIMBERLY MAHONEY
Valid signature Filed with authorized/valid electronic signature
MRI ASSOCIATES OF ST. PETE, INC. 401(K) PSP 2014 593483191 2015-09-30 MRI ASSOCIATES OF ST. PETE, INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621498
Sponsor’s telephone number 7275772220
Plan sponsor’s address 750 94TH AVE. NORTH, SUITE 206, ST. PETERSBURG, FL, 33702

Signature of
Role Plan administrator
Date 2015-09-30
Name of individual signing KIMBERLY MAHONEY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Lacy Peyton A Agent 750 94TH AVE NORTH, ST. PETERSBURG, FL, 33702

Treasurer

Name Role Address
LACY PEYTON TDr. Treasurer 750 94TH AVE NORTH, ST. PETERSBURG, FL, 33702

President

Name Role Address
McCormick Michael President 750 94TH AVE NORTH, ST. PETERSBURG, FL, 33702

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G14000004336 LARGO SLEEP DIAGNOSTICS EXPIRED 2014-01-13 2019-12-31 No data 750 94TH AVENUE NORTH, SUITE 208, ST. PETERSBURG, FL, 33702
G14000004338 SAINT PETE SLEEP DIAGNOSTICS EXPIRED 2014-01-13 2024-12-31 No data 750 94TH AVENUE NORTH, SUITE 208, ST. PETERSBURG, FL, 33702
G10000084873 SAINT PETE MRI ACTIVE 2010-09-16 2025-12-31 No data 750 94TH AVE NORTH, SUITE 206, SAINT PETERSBURG, FL, 33702
G06292700060 SAINT PETE DIAGNOSTIC IMAGING ACTIVE 2006-10-19 2026-12-31 No data 750 94TH AVE NORTH, SUITE 206, SAINT PETERSBURG, FL, 33702
G06292700062 SAINT PETE MRI & DIAGNOSTIC IMAGING ACTIVE 2006-10-19 2026-12-31 No data 750 94TH AVE N STE 206, SAINT PETERSBURG, FL, 33702

Related by officers

McCormick Michael

ST. JOHNS GOLF & COUNTRY CLUB COMMUNITY ASSOCIATION, INC. REV-WAY OF FLORIDA, INC.

Related by address

No related companies by address

Date of last update: 03 Jan 2025

Sources: Florida Department of State

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