| Entity Name: | GREENE UROLOGICAL CENTER, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 22 Apr 1999 (26 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | P99000037854 |
| FEI/EIN Number | 593570433 |
| Address: | 308 PALMETTO STREET, NEW SMYRNA BEACH, FL, 32168 |
| Mail Address: | 308 PALMETTO STREET, NEW SMYRNA BEACH, FL, 32168 |
| ZIP code: | 32168 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710172861 | 2007-09-12 | 2014-10-27 | 308 PALMETTO ST, NEW SMYRNA BEACH, FL, 321687136, US | 308 PALMETTO ST, NEW SMYRNA BEACH, FL, 321687136, US | |||||||||||||||||||
|
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| Phone | +1 386-426-2565 |
Authorized person
| Name | MRS. CAROL GREENE |
| Role | OFFICE MANAGER |
| Phone | 3864262565 |
Taxonomy
| Taxonomy Code | 208800000X - Urology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 379897600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GREENE JOHN EM.D. | Agent | 308 PALMETTO STREET, NEW SMYRNA BEACH, FL, 32168 |
| Name | Role | Address |
|---|---|---|
| GREENE JOHN EM.D. | President | 308 PALMETTO STREET, NEW SMYRNA BEACH, FL, 32168 |
| Name | Role | Address |
|---|---|---|
| GREENE JOHN EM.D. | Secretary | 308 PALMETTO STREET, NEW SMYRNA BEACH, FL, 32168 |
| Name | Role | Address |
|---|---|---|
| GREENE JOHN EM.D. | Treasurer | 308 PALMETTO STREET, NEW SMYRNA BEACH, FL, 32168 |
| Name | Role | Address |
|---|---|---|
| GREENE JOHN EM.D. | Director | 308 PALMETTO STREET, NEW SMYRNA BEACH, FL, 32168 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-19 | 308 PALMETTO STREET, NEW SMYRNA BEACH, FL 32168 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-04-19 | GREENE, JOHN E., M.D. | No data |
| CANCEL ADM DISS/REV | 2009-10-26 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2008-07-03 | 308 PALMETTO STREET, NEW SMYRNA BEACH, FL 32168 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-04-29 | 308 PALMETTO STREET, NEW SMYRNA BEACH, FL 32168 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-04-26 |
| ANNUAL REPORT | 2015-04-07 |
| ANNUAL REPORT | 2014-04-22 |
| ANNUAL REPORT | 2013-04-19 |
| ANNUAL REPORT | 2012-04-25 |
| ANNUAL REPORT | 2011-04-21 |
| ANNUAL REPORT | 2010-09-16 |
| REINSTATEMENT | 2009-10-26 |
| ANNUAL REPORT | 2008-07-03 |
| ANNUAL REPORT | 2007-07-10 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
