| Entity Name: | KEITH R. GOLDSTEIN, D.P.M., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 11 Jan 2001 (24 years ago) |
| Document Number: | P01000004140 |
| FEI/EIN Number | 593691416 |
| Address: | 1317 Edgewater Drive, Orlando, FL, 32804, US |
| Mail Address: | 1317 Edgewater Drive, Orlando, FL, 32804, US |
| ZIP code: | 32804 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568762979 | 2010-11-01 | 2010-11-10 | 7634 SPRING BAY CV, ORLANDO, FL, 328197207, US | 7634 SPRING BAY CV, ORLANDO, FL, 328197207, US | |||||||||||||||||||
|
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| Phone | +1 407-509-8852 |
| Fax | 4073636816 |
Authorized person
| Name | DR. KEITH ROY GOLDSTEIN |
| Role | PRESIDENT |
| Phone | 4075098852 |
Taxonomy
| Taxonomy Code | 213E00000X - Podiatrist |
| License Number | PO 2436 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GOLDSTEIN KEITH R | Agent | 1317 Edgewater Drive, Orlando, FL, 32804 |
| Name | Role | Address |
|---|---|---|
| GOLDSTEIN KEITH R | President | 1317 Edgewater Drive, Orlando, FL, 32804 |
| Name | Role | Address |
|---|---|---|
| GOLDSTEIN KEITH R | Secretary | 1317 Edgewater Drive, Orlando, FL, 32804 |
| Name | Role | Address |
|---|---|---|
| GOLDSTEIN KEITH R | Treasurer | 1317 Edgewater Drive, Orlando, FL, 32804 |
| Name | Role | Address |
|---|---|---|
| GOLDSTEIN KEITH R | Director | 1317 Edgewater Drive, Orlando, FL, 32804 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
