| Entity Name: | DIANA BARRENECHE, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Mar 2005 (20 years ago) |
| Last Event: | AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 15 Jun 2016 (9 years ago) |
| Document Number: | P05000046489 |
| FEI/EIN Number | 020741704 |
| Address: | 7100 W. CAMINO REAL, BOCA RATON, FL, 33433, US |
| Mail Address: | 6579 VIA REGINA, BOCA RATON, FL, 33433, US |
| ZIP code: | 33433 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053788851 | 2015-08-27 | 2017-10-11 | 102 NE 2ND ST STE 210, BOCA RATON, FL, 334323908, US | 7100 W CAMINO REAL STE 200, BOCA RATON, FL, 334335510, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 561-674-2859 |
| Fax | 5615710316 |
Authorized person
| Name | DR. DIANA MARIA BARRENECHE |
| Role | PRESIDENT/OWNER |
| Phone | 3059652016 |
Taxonomy
| Taxonomy Code | 231H00000X - Audiologist |
| License Number | AY1546 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | S0035 |
| State | FL |
| Issuer | MEDICAID |
| Number | 003416500 |
| State | FL |
| Issuer | MEDICARE PTAN |
| Number | IJ412A |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BARRENECHE DIANA | Agent | 7100 West Camino Real, BOCA RATON, FL, 33433 |
| Name | Role | Address |
|---|---|---|
| BARRENECHE DIANA Dr. | Director | 7100 W. CAMINO REAL, BOCA RATON, FL, 33433 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-02 | 7100 W. CAMINO REAL, SUITE 302-14, BOCA RATON, FL 33433 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-02 | 7100 W. CAMINO REAL, SUITE 302-14, BOCA RATON, FL 33433 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-02 | 7100 West Camino Real, Suite #302-14, BOCA RATON, FL 33433 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-06-15 | BARRENECHE, DIANA | No data |
| AMENDMENT AND NAME CHANGE | 2016-06-15 | DIANA BARRENECHE, INC | No data |
| REINSTATEMENT | 2010-07-26 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-01-10 |
| ANNUAL REPORT | 2022-03-29 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-01-18 |
| ANNUAL REPORT | 2019-01-27 |
| ANNUAL REPORT | 2018-01-31 |
| ANNUAL REPORT | 2017-01-06 |
| Amendment and Name Change | 2016-06-15 |
| ANNUAL REPORT | 2016-04-22 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
