| Entity Name: | CRYSTAL K. HAZELWOOD & ASSOCIATES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 11 Jul 2001 (24 years ago) |
| Date of dissolution: | 15 Apr 2016 (9 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 15 Apr 2016 (9 years ago) |
| Document Number: | P01000068039 |
| FEI/EIN Number | 593725500 |
| Address: | 56 MITCHELL AVE., ORANGE PARK, FL, 32073 |
| Mail Address: | 56 MITCHELL AVE., ORANGE PARK, FL, 32073 |
| ZIP code: | 32073 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205900644 | 2006-11-18 | 2020-08-22 | 56 MITCHELL AVE, ORANGE PARK, FL, 320735965, US | 1950 MILLER ST, SUITE 6, ORANGE PARK, FL, 320734759, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-269-4783 |
| Fax | 9042692949 |
| Phone | +1 904-269-5356 |
| Fax | 9042692088 |
Authorized person
| Name | MRS. CRYSTAL K HAZELWOOD |
| Role | PRESIDENT |
| Phone | 9042694783 |
Taxonomy
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| License Number | CAP1893L |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH4540 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 101YS0200X - School Counselor |
| License Number | 614406 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| HAZELWOOD ROBERT H | Agent | 56 MITCHELL AVE., ORANGE PARK, FL, 32073 |
| Name | Role | Address |
|---|---|---|
| HAZELWOOD CRYSTAL K | President | 56 MITCHELL AVE., ORANGE PARK, FL, 32073 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2016-04-15 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-05-07 | 56 MITCHELL AVE., ORANGE PARK, FL 32073 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2016-04-15 |
| ANNUAL REPORT | 2015-04-22 |
| ANNUAL REPORT | 2014-04-03 |
| ANNUAL REPORT | 2013-04-08 |
| ANNUAL REPORT | 2012-03-30 |
| ANNUAL REPORT | 2011-04-07 |
| ANNUAL REPORT | 2010-03-23 |
| ANNUAL REPORT | 2009-03-29 |
| ANNUAL REPORT | 2008-05-13 |
| ANNUAL REPORT | 2007-05-07 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
