| Entity Name: | GILLIOM AUDIOLOGY, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 19 Sep 1995 (29 years ago) |
| Document Number: | P95000072201 |
| FEI/EIN Number | 593337846 |
| Address: | 2051 ART MUSEUM DR., STE. #130, JACKSONVILLE, FL, 32207, US |
| Mail Address: | 2051 ART MUSEUM DR., STE. #130, JACKSONVILLE, FL, 32207, US |
| ZIP code: | 32207 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528215639 | 2008-08-20 | 2008-08-20 | 2051 ART MUSEUM DR, JACKSONVILLE, FL, 322072596, US | 2051 ART MUSEUM DR, JACKSONVILLE, FL, 322072596, US | |||||||||||||||||||
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| Phone | +1 904-399-3323 |
| Fax | 9043993360 |
Authorized person
| Name | DR. NANCY GILLIOM |
| Role | PRESIDENT |
| Phone | 9043993323 |
Taxonomy
| Taxonomy Code | 231H00000X - Audiologist |
| License Number | AY741 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BERG REBECCA L | Agent | 4811 BEACH BLVD, JACKSONVILLE, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| GILLIOM NANCY A | Director | 2051 ART MUSEUM SUITE 130, JACKSONVILLE, FL, 32207 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-12-24 | No data | No data |
| REINSTATEMENT | 1999-12-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1999-09-24 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
