| Entity Name: | NORTHERN AUDIOLOGY ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 07 Aug 2000 (25 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 19 Sep 2018 (6 years ago) |
| Document Number: | P00000076070 |
| FEI/EIN Number | 651028189 |
| Address: | 5702 Lake Worth Rd, Greenacres, FL, 33463, US |
| Mail Address: | 5702 Lake Worth Rd, Greenacres, FL, 33463, US |
| ZIP code: | 33463 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518988773 | 2006-07-22 | 2015-03-23 | 1325 S CONGRESS AVE, STE. 107, BOYNTON BEACH, FL, 334265876, US | 1325 S CONGRESS AVE, STE. 107, BOYNTON BEACH, FL, 334265876, US | |||||||||||||||||||||||||||
|
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| Phone | +1 561-742-7559 |
| Fax | 5617427957 |
Authorized person
| Name | MS. ELLEN SLOAN |
| Role | PARTNER/AUDIOLOGIST |
| Phone | 5617427559 |
Taxonomy
| Taxonomy Code | 231H00000X - Audiologist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | J8041 |
| State | FL |
| Issuer | AETNA HMO NUMBER |
| Number | 2497667 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ZAMORA JUAN D | Agent | 5702 Lake Worth Rd, Greenacres, FL, 33463 |
| Name | Role | Address |
|---|---|---|
| WALTERS TERRY | President | 5702 Lake Worth Rd, Greenacres, FL, 33463 |
| Name | Role | Address |
|---|---|---|
| WALTERS JENNY | Secretary | 5702 Lake Worth Rd, Greenacres, FL, 33463 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-12 | 5702 Lake Worth Rd, Suite 4, Greenacres, FL 33463 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-12 | 5702 Lake Worth Rd, Suite 4, Greenacres, FL 33463 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-12 | 5702 Lake Worth Rd, Suite 4, Greenacres, FL 33463 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-12-20 | ZAMORA, JUAN D | No data |
| AMENDMENT | 2018-09-19 | No data | No data |
| AMENDMENT | 2018-09-06 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-28 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-03-17 |
| ANNUAL REPORT | 2021-02-22 |
| ANNUAL REPORT | 2020-06-03 |
| Reg. Agent Change | 2019-12-20 |
| ANNUAL REPORT | 2019-01-22 |
| Amendment | 2018-09-19 |
| Amendment | 2018-09-06 |
| ANNUAL REPORT | 2018-04-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
