| Entity Name: | AUDIOLOGY AND SPEECH PATHOLOGY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 17 Jul 1986 (39 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: | J24823 |
| FEI/EIN Number | 59-2692324 |
| Address: | % MANLEY P. CALDWELL, JR., 3540 FOREST HILL BLVD.,#205, WEST PALM BEACH, FL 33406 |
| Mail Address: | % MANLEY P. CALDWELL, JR., 3540 FOREST HILL BLVD.,#205, WEST PALM BEACH, FL 33406 |
| ZIP code: | 33406 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285637892 | 2005-05-27 | 2008-04-29 | 3540 FOREST HILL BLVD, STE 205, WEST PALM BEACH, FL, 334065878, US | 3540 FOREST HILL BLVD, STE 205, WEST PALM BEACH, FL, 334065878, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 561-649-4006 |
| Fax | 5619696621 |
Authorized person
| Name | MEL GRANT |
| Role | PRESIDENT |
| Phone | 5616494006 |
Taxonomy
| Taxonomy Code | 231H00000X - Audiologist |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 600037108 |
| State | FL |
| Issuer | BCBS |
| Number | T0938 |
| State | FL |
| Issuer | MEDICAID |
| Number | 600037110 |
| State | FL |
| Issuer | MEDICAID |
| Number | 600037100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CALDWELL, MANLEY P., JR. | Agent | 324 ROYAL PALM WAY, PALM BEACH, FL 33480 |
| Name | Role | Address |
|---|---|---|
| GRANT, MELVIN L. | DR. | 12720 HEADWATER CIRCLE, WELLINGTON, FL 33414 |
| Name | Role | Address |
|---|---|---|
| WENDY, GRANT | MRS. | 12720 HEADWATER CIRCLE, WELLINGTON, FL 33414 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CANCEL ADM DISS/REV | 2008-10-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-10-24 | % MANLEY P. CALDWELL, JR., 3540 FOREST HILL BLVD.,#205, WEST PALM BEACH, FL 33406 | No data |
| CHANGE OF MAILING ADDRESS | 2008-10-24 | % MANLEY P. CALDWELL, JR., 3540 FOREST HILL BLVD.,#205, WEST PALM BEACH, FL 33406 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-06-21 |
| ANNUAL REPORT | 2010-04-07 |
| ANNUAL REPORT | 2009-05-25 |
| REINSTATEMENT | 2008-10-24 |
| ANNUAL REPORT | 2007-01-12 |
| ANNUAL REPORT | 2006-04-02 |
| ANNUAL REPORT | 2005-01-16 |
| ANNUAL REPORT | 2004-07-23 |
| ANNUAL REPORT | 2003-04-23 |
| ANNUAL REPORT | 2002-02-24 |
Date of last update: 04 Feb 2025
Sources: Florida Department of State
