| Entity Name: | NEUROMUSCULAR ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 31 Dec 1990 (34 years ago) |
| Document Number: | S22072 |
| FEI/EIN Number | 593064039 |
| Address: | 4701 NORTH FEDERAL HWY, STE 311, POMPANO BEACH, FL, 33064 |
| Mail Address: | 4701 north federal HWY STE 311 box, Pompano, FL, 33064, US |
| ZIP code: | 33064 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437341070 | 2007-08-17 | 2007-08-17 | 418 N RIVER DR, DEERFIELD BEACH, FL, 334412043, US | 4701 N FED HWY, SUITE # 311, BOX 9-A, LIGHTHOUSE POINT, FL, 33064, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 954-993-7502 |
Authorized person
| Name | DR. DAVID J PENNELL |
| Role | OWNER |
| Phone | 9549937502 |
Taxonomy
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| License Number | AP215 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| License Number | MA37160 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | C2425 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | C0079 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PENNELL, DAVID | Agent | 4701 north federal HWY STE 311, Pompano, FL, 33064 |
| Name | Role | Address |
|---|---|---|
| Pennell David | President | 4701 north federal HWY STE 311, Pompano, FL, 33064 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000043742 | SKIN CARE & BEAUTY ASSOCIATES | ACTIVE | 2017-04-22 | 2027-12-31 | No data | 4701 N. FEDERAL HWY, SUITE 311, POMPANO BEACH, FL, 33064 |
| G10000072228 | ACCIDENT & INJURY CENTER OF BROWARD | EXPIRED | 2010-08-05 | 2015-12-31 | No data | 4701 N FEDERAL HWY SUITE 311, POMPANO, FL, 33064 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
