| Entity Name: | JO ELLEN TOMLINSON OD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 07 Dec 2007 (17 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | L07000121912 |
| FEI/EIN Number | 743244310 |
| Address: | 207 OAKLAKE COVE, NICEVILLE, FL, 32578, US |
| Mail Address: | 207 OAKLAKE COVE, NICEVILLE, FL, 32578, US |
| ZIP code: | 32578 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649444332 | 2008-04-15 | 2008-07-07 | PO BOX 416, VALPARAISO, FL, 325800416, US | 1226 FREEPORT HWY S, DEFUNIAK SPRINGS, FL, 324353396, US | |||||||||||||||||||||||||||||||
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| Phone | +1 850-892-4022 |
| Fax | 8508923975 |
Authorized person
| Name | JO ELLEN TOMLINSON |
| Role | OWNER |
| Phone | 8508924022 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC2567 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 20416 |
| State | FL |
| Issuer | MEDICAID |
| Number | 620133400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TOMLINSON JO ELLEN | Agent | 207 OAKLAKE COVE, NICEVILLE, FL, 32578 |
| Name | Role | Address |
|---|---|---|
| TOMLINSON JO ELLEN | Managing Member | 207 OAKLAKE COVE, NICEVILLE, FL, 32578 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-01-14 |
| ANNUAL REPORT | 2017-01-08 |
| ANNUAL REPORT | 2016-03-02 |
| ANNUAL REPORT | 2015-01-28 |
| ANNUAL REPORT | 2014-03-05 |
| ANNUAL REPORT | 2013-03-20 |
| ANNUAL REPORT | 2012-04-23 |
| ANNUAL REPORT | 2011-04-22 |
| ANNUAL REPORT | 2010-02-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
