| Entity Name: | ALLIETE ALFANO, SLP, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 24 Jul 2003 (22 years ago) |
| Document Number: | P03000081512 |
| FEI/EIN Number | 200124906 |
| Address: | 4960 SW 72nd Ave, Miami, FL, 33155, US |
| Mail Address: | 4960 SW 72nd Ave, Miami, FL, 33155, US |
| ZIP code: | 33155 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508824574 | 2006-05-01 | 2024-01-01 | 4960 SW 72ND AVE STE 210, MIAMI, FL, 331555549, US | 4960 SW 72ND AVE STE 210, MIAMI, FL, 331555549, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 305-461-4702 |
| Fax | 3054614705 |
| Fax | 3054614702 |
Authorized person
| Name | DR. ALLIETE ALFANO |
| Role | PRESIDENT |
| Phone | 3054614702 |
Taxonomy
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| License Number | SA5335 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 890596700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ALFANO ALLIETE R | Agent | 4960 SW 72nd Ave, Miami, FL, 33155 |
| Name | Role | Address |
|---|---|---|
| ALFANO ALLIETE R | President | 4960 SW 72nd Ave, Miami, FL, 33155 |
| Name | Role | Address |
|---|---|---|
| ALFANO ALLIETE R | Vice President | 4960 SW 72nd Ave, Miami, FL, 33155 |
| Name | Role | Address |
|---|---|---|
| ALFANO ALLIETE R | Secretary | 4960 SW 72nd Ave, Miami, FL, 33155 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000039131 | THE ALFANO CENTER | ACTIVE | 2012-04-25 | 2027-12-31 | No data | 4960 SW 72ND AVE #210, MIAMI, FL, 33155 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-09 | 4960 SW 72nd Ave, 210, Miami, FL 33155 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-09 | 4960 SW 72nd Ave, 210, Miami, FL 33155 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-09 | 4960 SW 72nd Ave, 210, Miami, FL 33155 | No data |
| REGISTERED AGENT NAME CHANGED | 2009-03-23 | ALFANO, ALLIETE RDR. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-09 |
| ANNUAL REPORT | 2023-03-27 |
| ANNUAL REPORT | 2022-01-19 |
| ANNUAL REPORT | 2021-02-03 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-01-29 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-01-28 |
| ANNUAL REPORT | 2016-01-15 |
| ANNUAL REPORT | 2015-01-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
