| Entity Name: | HENDRY DIAGNOSTIC IMAGING CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 21 Apr 1999 (26 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P99000036500 |
| FEI/EIN Number | 65-0916106 |
| Mail Address: | PO BOX 151908, CAPE CORAL, FL 33915 |
| Address: | 1008 WEST SAGAMORE AVE, CLEWISTON, FL 33440 |
| ZIP code: | 33440 |
| County: | Hendry |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295862605 | 2007-02-27 | 2008-02-01 | PO BOX 151908, CAPE CORAL, FL, 339151908, US | 1008 W SAGAMORE AVE, CLEWISTON, FL, 334403420, US | |||||||||||||||||||||||||
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| Phone | +1 239-242-5237 |
| Fax | 2392427274 |
| Phone | +1 863-983-1103 |
| Fax | 8639830307 |
Authorized person
| Name | VICTOR C BASILE |
| Role | DIRECTOR |
| Phone | 8639831103 |
Taxonomy
| Taxonomy Code | 261QM1200X - Magnetic Resonance Imaging (MRI) Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS# MEDICAL DIRECTOR |
| Number | 27010A |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BASILE, VICTOR C | Agent | 3011 S.W. 10TH AVE, CAPE CORAL, FL 33914 |
| Name | Role | Address |
|---|---|---|
| BASILE, VICTOR C | President | 3011 S.W. 10TH AVE, CAPE CORAL, FL 33914 |
| Name | Role | Address |
|---|---|---|
| BASILE, VICTOR C | Director | 3011 S.W. 10TH AVE, CAPE CORAL, FL 33914 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2011-05-01 | 1008 WEST SAGAMORE AVE, CLEWISTON, FL 33440 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-09-11 | 1008 WEST SAGAMORE AVE, CLEWISTON, FL 33440 | No data |
| REGISTERED AGENT NAME CHANGED | 2005-09-11 | BASILE, VICTOR C | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-09-11 | 3011 S.W. 10TH AVE, CAPE CORAL, FL 33914 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-05-01 |
| ANNUAL REPORT | 2010-04-21 |
| ANNUAL REPORT | 2009-04-30 |
| ANNUAL REPORT | 2008-04-29 |
| ANNUAL REPORT | 2007-04-24 |
| ANNUAL REPORT | 2006-04-27 |
| ANNUAL REPORT | 2005-09-11 |
| ANNUAL REPORT | 2005-04-04 |
| Reg. Agent Change | 2004-06-02 |
| ANNUAL REPORT | 2004-02-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
