| Entity Name: | HOMESTEAD DIAGNOSTIC CENTER INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 10 Mar 1999 (26 years ago) |
| Document Number: | P99000022400 |
| FEI/EIN Number | 65-0902487 |
| Address: | 650 NE 22nd Terr., 100, HOMESTEAD, FL 33033 |
| Mail Address: | 650 NE 22nd Terr., 100, HOMESTEAD, FL 33033 |
| ZIP code: | 33033 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891717971 | 2006-07-24 | 2020-08-20 | 650 NE 22ND TER STE 100, HOMESTEAD, FL, 330334710, US | 650 NE 22ND TER STE 100, HOMESTEAD, FL, 330334710, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-785-1048 |
| Fax | 3052461320 |
| Phone | +1 305-246-5600 |
Authorized person
| Name | MR. TOMAS GONZALEZ |
| Role | PRESIDENT |
| Phone | 3052465600 |
Taxonomy
| Taxonomy Code | 261QR0200X - Radiology Clinic/Center |
| License Number | 13-64-06259 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | V2443 |
| State | FL |
| Issuer | MEDICAID |
| Number | 256719900 |
| State | FL |
| Issuer | AVMED |
| Number | 266961 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MORRABAL, NAYIBE | Agent | 650 NE 22nd Terr., 100, HOMESTEAD, FL 33033 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ, TOMAS | President | 650 NE 22nd Terr., 100 HOMESTEAD, FL 33033 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-02-07 | 650 NE 22nd Terr., 100, HOMESTEAD, FL 33033 | No data |
| CHANGE OF MAILING ADDRESS | 2018-02-07 | 650 NE 22nd Terr., 100, HOMESTEAD, FL 33033 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-02-07 | 650 NE 22nd Terr., 100, HOMESTEAD, FL 33033 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-04-10 | MORRABAL, NAYIBE | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-06 |
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-02-05 |
| ANNUAL REPORT | 2020-04-28 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-02-07 |
| ANNUAL REPORT | 2017-02-13 |
| ANNUAL REPORT | 2016-03-16 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
