| Entity Name: | NASSBERG DIABETES ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 Aug 2000 (25 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 16 Apr 2018 (7 years ago) |
| Document Number: | P00000075455 |
| FEI/EIN Number | 651029746 |
| Address: | 5333 N. Dixie Hwy, Suite 205, Oakland Park, FL, 33334, US |
| Mail Address: | 5333 N. Dixie Hwy, Suite 205, Oakland Park, FL, 33334, US |
| ZIP code: | 33334 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891000543 | 2010-08-18 | 2023-12-28 | 5333 N DIXIE HWY STE 205, OAKLAND PARK, FL, 333343454, US | 5333 N DIXIE HWY STE 205, OAKLAND PARK, FL, 333343454, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-491-1000 |
| Fax | 9549387923 |
Authorized person
| Name | BETH CAMHI-GREENBERG |
| Role | OWNER |
| Phone | 9544911000 |
Taxonomy
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAL LICENSE |
| Number | ME16517 |
| State | FL |
| Issuer | RN LICENSE |
| Number | RN9490906 |
| State | FL |
| Issuer | NATIONAL PROVIDER ID |
| Number | 1215363593 |
| State | FL |
| Issuer | NATIONAL PROVIDER |
| Number | 1710957832 |
| State | SC |
| Issuer | NATIONAL PROVIDER ID |
| Number | 1538301437 |
| State | FL |
| Issuer | LICENSE |
| Number | 9365653 |
| State | FL |
| Issuer | NATIONAL PROVIDER ID |
| Number | 1508572736 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CAMHI-GREENBERG BETH | Agent | 5333 N. Dixie Hwy, Oakland Park, FL, 33334 |
| Name | Role | Address |
|---|---|---|
| CAMHI-GREENBERG BETH | President | 5333 N. Dixie Hwy, Oakland Park, FL, 33334 |
| Name | Role | Address |
|---|---|---|
| CAMHI-GREENBERG BETH | Director | 5333 N. Dixie Hwy, Oakland Park, FL, 33334 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G25000023146 | FLORIDA DIABETES & ENDOCRINOLOGY | ACTIVE | 2025-02-15 | 2030-12-31 | No data | 6908 NEOPOLITAN CT, APOLLO BEACH, FL, 33572 |
| G25000023145 | NASSBERG DIABETES ASSOCIATES, INC. | ACTIVE | 2025-02-15 | 2030-12-31 | No data | 6908 NEOPOLITAN CT, APOLLO BEACH, FL, 33572 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-01-07 | 5333 N. Dixie Hwy, Suite 205, Oakland Park, FL 33334 | No data |
| CHANGE OF MAILING ADDRESS | 2025-01-07 | 5333 N. Dixie Hwy, Suite 205, Oakland Park, FL 33334 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-08 | 5333 N. Dixie Hwy, Suite 205, Oakland Park, FL 33334 | No data |
| NAME CHANGE AMENDMENT | 2018-04-16 | NASSBERG DIABETES ASSOCIATES, INC. | No data |
| REGISTERED AGENT NAME CHANGED | 2018-04-16 | CAMHI-GREENBERG, BETH | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| Reg. Agent Change | 2023-12-18 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-02-03 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-06-05 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-04-25 |
| Name Change | 2018-04-16 |
| ANNUAL REPORT | 2017-01-09 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5665277710 | 2020-05-01 | 0455 | PPP | SUITE # 309 1930 NE 47TH ST STE 309, FORT LAUDERDALE, FL, 33308-7729 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Feb 2025
Sources: Florida Department of State
