| Entity Name: | MOBILE AUDIOLOGY & HEARING AIDS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Jan 2020 (5 years ago) |
| Document Number: | L20000031331 |
| FEI/EIN Number | 844430270 |
| Address: | 8550 TOUCHTON RD APT 2236, JACKSONVILLE, FL, 32216, US |
| Mail Address: | 8550 TOUCHTON RD APT 2236, JACKSONVILLE, FL, 32216, AF |
| ZIP code: | 32216 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134758550 | 2020-04-07 | 2020-07-03 | 8550 TOUCHTON RD APT 2236, JACKSONVILLE, FL, 322162237, US | 905 BEACH BLVD STE B, JACKSONVILLE BEACH, FL, 322504303, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 904-445-1622 |
| Fax | 9042931815 |
Authorized person
| Name | KIMBERLY HELEN DESMOND |
| Role | AUDIOLOGIST/OWNER |
| Phone | 9044451622 |
Taxonomy
| Taxonomy Code | 231H00000X - Audiologist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FLORIDA AUDIOLOGY LICENSE |
| Number | AY2158 |
| State | FL |
| Issuer | MEDICAID |
| Number | 102216900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DESMOND KIMBERLY H | Agent | 8550 TOUCHTON RD APT 2236, JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| DESMOND KIMBERLY HMS | Manager | 8550 TOUCHTON RD APT 2236, JACKSONVILLE, FL, 32216 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-28 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-02-22 |
| Florida Limited Liability | 2020-01-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
