| Entity Name: | HARRIS, WILCOX AND DONOVAN, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 01 Jul 1979 (46 years ago) |
| Document Number: | 625820 |
| FEI/EIN Number | 591910113 |
| Address: | 1855 East West Parkway, Fleming Island, FL, 32003, US |
| Mail Address: | 1855 East West Parkway, Fleming Island, FL, 32003, US |
| ZIP code: | 32003 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710019435 | 2007-03-09 | 2021-11-05 | 1855 EASTWEST PKWY, FLEMING ISLAND, FL, 320036348, US | 1855 EASTWEST PKWY, FLEMING ISLAND, FL, 320036348, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 904-272-2020 |
| Fax | 9042725762 |
Authorized person
| Name | ERIC J KING |
| Role | ADMINISTRATOR |
| Phone | 9042722020 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | No |
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | No |
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| Is Primary | Yes |
| Taxonomy Code | 332H00000X - Eyewear Supplier |
| Is Primary | No |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | CB1273 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KING ERIC J | Agent | 1855 East West Parkway, Fleming Island, FL, 32003 |
| Name | Role | Address |
|---|---|---|
| DOWNER DONALD M | President | 1855 East West Parkway, Fleming Island, FL, 32003 |
| Name | Role | Address |
|---|---|---|
| PECORARO RUSSELL A | Vice President | 1855 East West Parkway, Fleming Island, FL, 32003 |
| Name | Role | Address |
|---|---|---|
| LEVINE LAWRENCE M | Treasurer | 1855 East West Parkway, Fleming Island, FL, 32003 |
| Name | Role | Address |
|---|---|---|
| Hayes David W | Secretary | 1855 East West Parkway, Fleming Island, FL, 32003 |
| DuPree Jameson P | Secretary | 1855 East West Parkway, Fleming Island, FL, 32003 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G08319900105 | MACULAR DEGENERATION AND DIABETES EYE INSTITUTE OF NORTHEAST FLORIDA | EXPIRED | 2008-11-14 | 2013-12-31 | No data | 2023 PROFESSIONAL CENTER DRIVE, ORANGE PARK, FL, 32073 |
| G91022000192 | CLAY EYE PHYSICIANS & SURGEONS | ACTIVE | 1991-01-22 | 2026-12-31 | No data | 2023 PROFESSIONAL CTR DR, ORANGE PARK, FL, 32073 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| NAME CHANGE AMENDMENT | 1989-02-22 | HARRIS, WILCOX AND DONOVAN, P.A. | No data |
| NAME CHANGE AMENDMENT | 1988-12-30 | WILCOX, HARRIS AND DONOVAN, P.A. | No data |
| EVENT CONVERTED TO NOTES | 1988-12-30 | No data | No data |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
