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  5. CHARLOTTE HEARING CENTER, INC.

CHARLOTTE HEARING CENTER, INC.

Company Details

Entity Name: CHARLOTTE HEARING CENTER, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 07 Aug 2001 (23 years ago)
Date of dissolution: 23 Sep 2022 (2 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 23 Sep 2022 (2 years ago)
Document Number: P01000077747
FEI/EIN Number 651128385
Address: 21216 OLEAN BOULEVARD, CENTRAL PLAZA WEST, SUITE 4, PORT CHARLOTTE, FL, 33952
Mail Address: 103 Colonial Street S.W., PORT CHARLOTTE, FL, 33952, US
ZIP code: 33952
County: Charlotte
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1801982863 2006-10-05 2020-08-22 21216 OLEAN BLVD, SUITE 4, PORT CHARLOTTE, FL, 339526722, US 21216 OLEAN BLVD, SUITE 4, PORT CHARLOTTE, FL, 339526722, US

Contacts
Phone +1 941-766-8886
Fax 9417668804

Authorized person
Name BETHANY LEE WALDEN
Role OWNER
Phone 9417668886

Taxonomy
Taxonomy Code 231H00000X - Audiologist
License Number AY211
State FL
Is Primary Yes

Other Provider Identifiers
Issuer R.R. MEDICARE
Number CJ2976
State FL
Issuer BLUE CROSS/BLUE SHIELD
Number J0825
State FL
Issuer BLUECROSS/BLUE SHIELD
Number T0849
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CHARLOTTE HEARING CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2020 651128385 2021-10-04 CHARLOTTE HEARING CENTER, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 9417668886
Plan sponsor’s address 21216 OLEAN BLVD., SUITE 4, PORT CHARLOTTE, FL, 33952

Plan administrator’s name and address
Administrator’s EIN 651128385
Plan administrator’s name CHARLOTTE HEARING CENTER, INC.
Plan administrator’s address 103 COLONIAL STREET S.W., PORT CHARLOTTE, FL, 33952
Administrator’s telephone number 9417668886

Signature of
Role Plan administrator
Date 2021-10-04
Name of individual signing BETHANY L. WALDEN
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE HEARING CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2019 651128385 2020-07-30 CHARLOTTE HEARING CENTER, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 9417668886
Plan sponsor’s address 21216 OLEAN BLVD., SUITE 4, PORT CHARLOTTE, FL, 33952

Plan administrator’s name and address
Administrator’s EIN 651128385
Plan administrator’s name CHARLOTTE HEARING CENTER, INC.
Plan administrator’s address 103 COLONIAL STREET S.W., PORT CHARLOTTE, FL, 33952
Administrator’s telephone number 9417668886

Signature of
Role Plan administrator
Date 2020-07-30
Name of individual signing BETHANY L. WALDEN
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE HEARING CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2018 651128385 2019-10-02 CHARLOTTE HEARING CENTER, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 9417668886
Plan sponsor’s address 21216 OLEAN BLVD., SUITE 4, PORT CHARLOTTE, FL, 33952

Plan administrator’s name and address
Administrator’s EIN 651128385
Plan administrator’s name CHARLOTTE HEARING CENTER, INC.
Plan administrator’s address 21327 BASSETT AVENUE, PORT CHARLOTTE, FL, 33952
Administrator’s telephone number 9416247551

Signature of
Role Plan administrator
Date 2019-10-02
Name of individual signing BETHANY L. WALDEN
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE HEARING CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2017 651128385 2018-07-08 CHARLOTTE HEARING CENTER, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 9417668886
Plan sponsor’s address 21216 OLEAN BLVD., SUITE 4, PORT CHARLOTTE, FL, 33952

Plan administrator’s name and address
Administrator’s EIN 651128385
Plan administrator’s name CHARLOTTE HEARING CENTER, INC.
Plan administrator’s address 21327 BASSETT AVENUE, PORT CHARLOTTE, FL, 33952
Administrator’s telephone number 9416247551

Signature of
Role Plan administrator
Date 2018-07-08
Name of individual signing BETHANY L. WALDEN
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE HEARING CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2016 651128385 2017-12-21 CHARLOTTE HEARING CENTER, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 9417668886
Plan sponsor’s address 21216 OLEAN BLVD., SUITE 4, PORT CHARLOTTE, FL, 33952

Plan administrator’s name and address
Administrator’s EIN 651128385
Plan administrator’s name CHARLOTTE HEARING CENTER, INC.
Plan administrator’s address 21327 BASSETT AVENUE, PORT CHARLOTTE, FL, 33952
Administrator’s telephone number 9416247551

Signature of
Role Plan administrator
Date 2017-12-21
Name of individual signing BETHANY L. WALDEN
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE HEARING CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2015 651128385 2016-10-11 CHARLOTTE HEARING CENTER, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 9417668886
Plan sponsor’s address 21216 OLEAN BLVD., SUITE 4, PORT CHARLOTTE, FL, 33952

Plan administrator’s name and address
Administrator’s EIN 651128385
Plan administrator’s name CHARLOTTE HEARING CENTER, INC.
Plan administrator’s address 21327 BASSETT AVENUE, PORT CHARLOTTE, FL, 33952
Administrator’s telephone number 9416247551

Signature of
Role Plan administrator
Date 2016-10-11
Name of individual signing BETHANY L. WALDEN
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE HEARING CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST 2014 651128385 2015-10-14 CHARLOTTE HEARING CENTER, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 9417668886
Plan sponsor’s address 21216 OLEAN BLVD., SUITE 4, PORT CHARLOTTE, FL, 33952

Plan administrator’s name and address
Administrator’s EIN 651128385
Plan administrator’s name CHARLOTTE HEARING CENTER, INC.
Plan administrator’s address 21327 BASSETT AVENUE, PORT CHARLOTTE, FL, 33952
Administrator’s telephone number 9416247551

Signature of
Role Plan administrator
Date 2015-10-14
Name of individual signing BETHANY L. WALDEN
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE HEARING CENTER INC 401 K PROFIT SHARING PLAN TRUST 2013 651128385 2014-07-06 CHARLOTTE HEARING CENTER, INC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 9412550095
Plan sponsor’s address 21327 BASSETT AVE, PORT CHARLOTTE, FL, 339521500

Signature of
Role Plan administrator
Date 2014-07-06
Name of individual signing DAN WALDEN
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE HEARING CENTER INC 401 K PROFIT SHARING PLAN TRUST 2012 651128385 2013-07-21 CHARLOTTE HEARING CENTER, INC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 9412550095
Plan sponsor’s address 21327 BASSETT AVE, PORT CHARLOTTE, FL, 339521500

Signature of
Role Plan administrator
Date 2013-07-21
Name of individual signing CHARLOTTE HEARING CENTER, INC
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE HEARING CENTER INC 401 K PROFIT SHARING PLAN TRUST 2011 651128385 2012-07-30 CHARLOTTE HEARING CENTER, INC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 9412550095
Plan sponsor’s address 21327 BASSETT AVE, PORT CHARLOTTE, FL, 339521500

Plan administrator’s name and address
Administrator’s EIN 651128385
Plan administrator’s name CHARLOTTE HEARING CENTER, INC
Plan administrator’s address 21327 BASSETT AVE, PORT CHARLOTTE, FL, 339521500
Administrator’s telephone number 9412550095

Signature of
Role Plan administrator
Date 2012-07-30
Name of individual signing CHARLOTTE HEARING CENTER, INC
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Walden Bethany LAu.D. Agent 103 ColonialStreet S.W., PORT CHARLOTTE, FL, 33952

President

Name Role Address
WALDEN BETHANY LAu.D. President 21216 OLEAN BOULEVARD, PORT CHARLOTTE, FL, 33952

Vice President

Name Role Address
WALDEN DANNY L Vice President 21216 OLEAN BLVD, CPW, SUITE 4, PORT CHARLOTTE, FL, 33952

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2022-09-23 No data No data
CHANGE OF MAILING ADDRESS 2021-04-29 21216 OLEAN BOULEVARD, CENTRAL PLAZA WEST, SUITE 4, PORT CHARLOTTE, FL 33952 No data
REGISTERED AGENT ADDRESS CHANGED 2021-04-29 103 ColonialStreet S.W., PORT CHARLOTTE, FL 33952 No data
REGISTERED AGENT NAME CHANGED 2016-01-24 Walden, Bethany L, Au.D. No data
CHANGE OF PRINCIPAL ADDRESS 2006-03-30 21216 OLEAN BOULEVARD, CENTRAL PLAZA WEST, SUITE 4, PORT CHARLOTTE, FL 33952 No data

Documents

Name Date
ANNUAL REPORT 2021-04-29
ANNUAL REPORT 2020-05-28
ANNUAL REPORT 2019-04-20
ANNUAL REPORT 2018-01-15
ANNUAL REPORT 2017-02-14
ANNUAL REPORT 2016-01-24
ANNUAL REPORT 2015-02-22
ANNUAL REPORT 2014-02-26
ANNUAL REPORT 2013-02-01
ANNUAL REPORT 2012-04-10

Related by officers

WALDEN DANNY L

J. FRANKLIN PROPERTIES LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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