| Entity Name: | RICHARD A. GREENE, O.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 27 Apr 1984 (41 years ago) |
| Document Number: | H00987 |
| FEI/EIN Number | 592403848 |
| Address: | 2225 A1A S, C2, ST. AUGUSTINE, FL, 32080 |
| Mail Address: | 2225 A1A S, C2, ST. AUGUSTINE, FL, 32080 |
| ZIP code: | 32080 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407151335 | 2011-01-25 | 2011-01-25 | 2225 A1A S, SUITE C2, SAINT AUGUSTINE, FL, 320802916, US | 2225 A1A S, SUITE C2, SAINT AUGUSTINE, FL, 320802916, US | |||||||||||||||||||||||||
|
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| Phone | +1 904-471-8750 |
| Fax | 9044715996 |
Authorized person
| Name | DR. RICHARD ALAN GREENE |
| Role | OPTOMETRIST/OWNER |
| Phone | 9044718750 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | FL1648 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI |
| Number | 1114039336 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GREENE, RICHARD | Agent | 2225 A1A S, ST AUGUSTINE, FL, 32080 |
| Name | Role | Address |
|---|---|---|
| GREENE, RICHARD A. | Director | 2225 A1A S C2, SAINT AUGUSTINE, FL, 32080 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-04-22 | No data | No data |
| REINSTATEMENT | 2003-11-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
| REINSTATEMENT | 1995-10-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1995-08-25 | No data | No data |
| REINSTATEMENT | 1994-10-24 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1994-08-26 | No data | No data |
| NAME CHANGE AMENDMENT | 1984-05-18 | RICHARD A. GREENE, O.D., P.A. | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
