| Entity Name: | ISLAND AUDIOLOGY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 19 Jul 2011 (14 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | L11000082653 |
| FEI/EIN Number | 452774064 |
| Address: | 13999 GULF BLVD., STE C-4, MADEIRA BEACH, FL, 33708, US |
| Mail Address: | 13999 GULF BLVD., STE C-4, MADEIRA BEACH, FL, 33708, US |
| ZIP code: | 33708 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811265051 | 2011-12-02 | 2011-12-02 | 13999 GULF BLVD STE C4, MADEIRA BEACH, FL, 337082677, US | 13999 GULF BLVD STE C4, MADEIRA BEACH, FL, 337082677, US | |||||||||||||||||
|
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| Phone | +1 727-329-8683 |
Authorized person
| Name | DR. HEIDI D ROBERTS-FORDHAM |
| Role | OWNER/AUDIOLOGIST |
| Phone | 7273298683 |
Taxonomy
| Taxonomy Code | 261QH0700X - Hearing and Speech Clinic/Center |
| License Number | AY1366 |
| State | FL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| AMERICAN SAFETY COUNCIL, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| FORDHAM DAVID | Managing Member | 12424 CAPRI CIRCLE N, TREASURE ISLAND, FL, 33706 |
| ROBERTS-FORDHAM HEIDI | Managing Member | 12424 CAPRI CIRCLE N, TREASURE ISLAND, FL, 33706 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-12-22 | 13999 GULF BLVD., STE C-4, MADEIRA BEACH, FL 33708 | No data |
| CHANGE OF MAILING ADDRESS | 2011-12-22 | 13999 GULF BLVD., STE C-4, MADEIRA BEACH, FL 33708 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-04-18 |
| ANNUAL REPORT | 2012-03-06 |
| Florida Limited Liability | 2011-07-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
