| Entity Name: | DME & ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 02 Jun 1987 (38 years ago) |
| Document Number: | M53098 |
| FEI/EIN Number | 592814639 |
| Mail Address: | 7100 Fairway Drive, Palm Beach Gardens, FL, 33418, US |
| Address: | 8198 S. JOG ROAD, BOYNTON BEACH, FL, 33472, US |
| ZIP code: | 33472 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821170820 | 2006-10-19 | 2024-06-14 | 8198 SOUTH JOG ROAD, SUITE #207, BOYNTON BEACH, FL, 33472, US | 8198 SOUTH JOG ROAD, SUITE #207, BOYNTON BEACH, FL, 33472, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 561-740-2045 |
| Fax | 5617202414 |
Authorized person
| Name | MR. IAN NAGLE |
| Role | DIRECTOR OF OPERATIONS |
| Phone | 5617402045 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT 3635 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS PROVIDER NUMBER |
| Number | Y913A |
| State | FL |
| Issuer | GHI PROVIDER NUMBER |
| Number | 6696980 |
| State | FL |
| Issuer | AETNA PROVIDER NUMBER |
| Number | 7837593 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Fairway Physical Therapy | Agent | 5474 NW 120TH AVE, CORAL SPRINGS, FL, 33076 |
| Name | Role | Address |
|---|---|---|
| Richman Brett S | President | 7100 Fairway Drive, Palm Beach Gardens, FL, 33418 |
| Name | Role | Address |
|---|---|---|
| Richman Brett S | Director | 7100 Fairway Drive, Palm Beach Gardens, FL, 33418 |
| Name | Role | Address |
|---|---|---|
| NAGLE JENNY F | Treasurer | 5474 NW 120TH AVE, CORAL SPRINGS, FL, 33076 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2002-06-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2001-09-21 | No data | No data |
| NAME CHANGE AMENDMENT | 1998-02-17 | DME & ASSOCIATES, INC. | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
