DWIGHT H EISENMAN
Mental Health at Turtle Bay Ln, Ponte Vedra, FL

License number
Florida 9450
Issued Date
Oct 12, 2011
Effective Date
Aug 18, 2016
Expiration Date
Mar 31, 2015
Category
Health Care
Type
Registered Mental Health Counselor Intern
Address
Address 2
145 Turtle Bay Ln, Ponte Vedra, FL 32082
4851 W Hillsboro Blvd, Pompano Beach, FL 33073
Phone
(954) 235-2580
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

Organization information

See more information about DWIGHT H EISENMAN at bizstanding.com

DWIGHT H. EISENMAN, PA

Ponte Vedra, FL  -  Fort Lauderdale, FL

Status:
Inactive
Industry:
Business Services at Non-Commercial Site, Nonclassifiable Establishments
Inactive reason:
AMENDMENT
Registration:
Nov 8, 2011
Inactive since:
Jun 29, 2015
Addresses:
145 Turtle Bay Ln, Ponte Vedra Beach, FL 32082 (Physical)
1812 NW 36 Ct, Fort Lauderdale, FL 33309 (Mailing)
State ID:
P11000096972
Business type:
Florida Profit Corporation
President:
Dwight H Eisenman (President), 145 Turtle Bay Ln, Ponte Vedra Beach, FL 32082 (Physical)
Agent:
Judith Carlson,1812 NW 36 Ct, Fort Lauderdale, FL 33309 (Physical)
EIN:
45-3770153

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