| Entity Name: | GORDON GRENN, D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
GORDON GRENN, D.O., P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 01 Nov 1977 (47 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 25 Sep 1995 (30 years ago) |
| Document Number: | 549854 |
| FEI/EIN Number |
591773343
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | C/O GORDON GRENN, 4002 RAULERSON ROAD, LAKE WORTH, FL, 33463, US |
| Mail Address: | C/O GORDON GRENN, 4002 RAULERSON ROAD, LAKE WORTH, FL, 33463, US |
| ZIP code: | 33463 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326348681 | 2010-11-02 | 2011-05-17 | 4002 RAULERSON DR, LAKE WORTH, FL, 334638927, US | 4002 RAULERSON DR, LAKE WORTH, FL, 334638927, US | |||||||||||||||||||||||||
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| Phone | +1 561-964-4077 |
| Fax | 5619649296 |
Authorized person
| Name | DR. GORDON L. GRENN |
| Role | DOCTOR |
| Phone | 5619644077 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS0003345 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 265885200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GRENN, GORDON L. | dr | C/O GORDON GRENN, LAKE WORTH, FL, 33463 |
| GRENN, JUDITH B. | Secretary | 3755 CANTERBURY WAY, BOCA RATON, FL |
| GRENN, GORDON | Agent | 4002 RAULERSON ROAD, LAKE WORTH, FL, 33463 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 1995-09-25 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1995-08-25 | - | - |
| REGISTERED AGENT NAME CHANGED | 1986-07-17 | GRENN, GORDON | - |
| NAME CHANGE AMENDMENT | 1986-07-17 | GORDON GRENN, D.O., P.A. | - |
| CHANGE OF PRINCIPAL ADDRESS | 1986-03-20 | C/O GORDON GRENN, 4002 RAULERSON ROAD, LAKE WORTH, FL 33463 | - |
| CHANGE OF MAILING ADDRESS | 1986-03-20 | C/O GORDON GRENN, 4002 RAULERSON ROAD, LAKE WORTH, FL 33463 | - |
| REGISTERED AGENT ADDRESS CHANGED | 1986-03-20 | 4002 RAULERSON ROAD, LAKE WORTH, FL 33463 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-02-13 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-02-26 |
| ANNUAL REPORT | 2020-02-07 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-02-09 |
| ANNUAL REPORT | 2016-02-06 |
| ANNUAL REPORT | 2015-04-11 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 9160927108 | 2020-04-15 | 0455 | PPP | 4002 RAULERSON DR, GREENACRES, FL, 33463-8927 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
