| Entity Name: | SPEECH PATHOLOGY ASSOCIATES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 09 May 2001 (24 years ago) |
| Date of dissolution: | 02 May 2016 (9 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 02 May 2016 (9 years ago) |
| Document Number: | P01000048512 |
| FEI/EIN Number | 582325850 |
| Address: | 1595 LINKSIDE DRIVE, ATLANTIC, FL, 32233 |
| Mail Address: | 1595 LINKSIDE DRIVE, ATLANTIC, FL, 32233 |
| ZIP code: | 32233 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295776763 | 2006-06-08 | 2020-08-22 | 1595 LINKSIDE DR, ATLANTIC BEACH, FL, 322337308, US | 1463 NECTARINE ST, FERNANDINA BEACH, FL, 320343027, US | |||||||||||||||||||||||||
|
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| Phone | +1 904-635-3179 |
| Fax | 9042467259 |
Authorized person
| Name | DEBORAH ROBERTS |
| Role | PRESIDENT/SPEECH PATHOLOGIST |
| Phone | 9046353179 |
Taxonomy
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| License Number | SA3317 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS/BLUE SHIELD |
| Number | S1829 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROBERTS DEBORAH | Agent | 1595 LINKSIDE DRIVE, ATLANTIC, FL, 32233 |
| Name | Role | Address |
|---|---|---|
| ROBERTS DEBORAH | President | 1595 LINKSIDE DRIVE, ATLANTIC, FL, 32233 |
| Name | Role | Address |
|---|---|---|
| ROBERTS DEBORAH | Director | 1595 LINKSIDE DRIVE, ATLANTIC, FL, 32233 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2016-05-02 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2007-04-22 | ROBERTS, DEBORAH | No data |
| Name | Date |
|---|---|
| Voluntary Dissolution | 2016-05-02 |
| ANNUAL REPORT | 2015-04-26 |
| ANNUAL REPORT | 2014-04-22 |
| ANNUAL REPORT | 2013-04-10 |
| ANNUAL REPORT | 2012-04-02 |
| ANNUAL REPORT | 2011-04-20 |
| ANNUAL REPORT | 2010-04-19 |
| ANNUAL REPORT | 2009-04-09 |
| ANNUAL REPORT | 2008-04-26 |
| ANNUAL REPORT | 2007-04-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
