| Entity Name: | JASON GREEN, DO, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 03 Jun 2008 (17 years ago) |
| Document Number: | P08000054660 |
| FEI/EIN Number | 262792350 |
| Address: | 260 SW Natura Avenue, Suite 101, Deerfield Beach, FL, 33441, US |
| Mail Address: | 260 SW Natura Avenue, Suite 101, Deerfield Beach, FL, 33441, US |
| ZIP code: | 33441 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649726316 | 2016-08-31 | 2016-08-31 | 260 SW NATURA AVE, SUITE 101, DEERFIELD BEACH, FL, 334413026, US | 260 SW NATURA AVE, SUITE 101, DEERFIELD BEACH, FL, 334413026, US | |||||||||||||||||||
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| Phone | +1 954-481-0650 |
| Fax | 9544810651 |
Authorized person
| Name | DR. JASON GREEN |
| Role | PHYSICIAN/OWNER |
| Phone | 9544810650 |
Taxonomy
| Taxonomy Code | 261QM2500X - Medical Specialty Clinic/Center |
| License Number | OS 88871 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GREEN JASON B | Agent | 729 NE BOCA BAY COLONY DRIVE, BOCA RATON, FL, 33487 |
| Name | Role | Address |
|---|---|---|
| GREEN JASON B | President | 729 NE BOCA BAY COLONY DRIVE, BOCA RATON, FL, 33487 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000122697 | DEERFIELD BEACH PATHOLOGY | ACTIVE | 2022-09-29 | 2027-12-31 | No data | 260 SW NATURA AVE, SUITE 101, DEERFIELD BEACH, FL, 33441 |
| G16000067149 | GREEN DERMATOLOGY & COSMETIC CENTER | ACTIVE | 2016-07-08 | 2026-12-31 | No data | 260 SW NATURA AVE #101, #101, DEERFIELD BEACH, FL, 33441 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-11 | 729 NE BOCA BAY COLONY DRIVE, BOCA RATON, FL 33487 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-03-21 | 260 SW Natura Avenue, Suite 101, Deerfield Beach, FL 33441 | No data |
| CHANGE OF MAILING ADDRESS | 2017-03-21 | 260 SW Natura Avenue, Suite 101, Deerfield Beach, FL 33441 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-24 |
| ANNUAL REPORT | 2023-01-21 |
| ANNUAL REPORT | 2022-03-10 |
| ANNUAL REPORT | 2021-03-26 |
| ANNUAL REPORT | 2020-03-24 |
| ANNUAL REPORT | 2019-04-11 |
| ANNUAL REPORT | 2018-03-31 |
| ANNUAL REPORT | 2017-03-21 |
| ANNUAL REPORT | 2016-04-13 |
| ANNUAL REPORT | 2015-02-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
