| Entity Name: | JEROLD S. GREENFIELD, O.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 23 Jan 2001 (24 years ago) |
| Document Number: | P01000009017 |
| FEI/EIN Number | 651085423 |
| Address: | 5100 N 9TH AVENUE, PENSACOLA, FL, 32504, US |
| Mail Address: | 3062 LARKHALL PLACE, MILTON, FL, 32583, US |
| ZIP code: | 32504 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518533728 | 2021-05-28 | 2021-06-09 | 5100 N 9TH AVE, PENSACOLA, FL, 325048735, US | 5100 N 9TH AVE, PENSACOLA, FL, 325048735, US | |||||||||||||||
|
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| Phone | +1 850-477-7646 |
| Fax | 8504777128 |
Authorized person
| Name | DR. JEROLD S GREENFIELD |
| Role | PROVIDER/OWNER |
| Phone | 9545366756 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GREENFIELD JEROLD S | Agent | 3062 LARKHALL PLACE, MILTON, FL, 32583 |
| Name | Role | Address |
|---|---|---|
| GREENFIELD JEROLD S | Director | 3062 LARKHALL PLACE, PENSACOLA, FL, 32583 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| NAME CHANGE AMENDMENT | 2001-02-13 | JEROLD S. GREENFIELD, O.D., P.A. | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
