| Entity Name: | CORAL SPRINGS VISION CARE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
CORAL SPRINGS VISION CARE, PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 09 Sep 2008 (17 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 10 Jun 2013 (12 years ago) |
| Document Number: | L08000085635 |
| FEI/EIN Number |
263317124
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 9773 W. SAMPLE ROAD, CORAL SPRINGS, FL, 33065, US |
| Mail Address: | 9773 W. SAMPLE ROAD, CORAL SPRINGS, FL, 33065, US |
| ZIP code: | 33065 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346564325 | 2010-03-20 | 2013-10-30 | 9773 W SAMPLE RD, CORAL SPRINGS, FL, 330654003, US | 9773 W SAMPLE RD, CORAL SPRINGS, FL, 330654003, US | |||||||||||||||||||||||||||||
|
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| Phone | +1 954-753-0137 |
| Fax | 9547530139 |
Authorized person
| Name | DR. KATHERINE ORELLANA-MEDINA |
| Role | MANAGER/OWNER |
| Phone | 9547530137 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC 3853 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE ID |
| Number | FM674A |
| Issuer | MEDICAID |
| Number | 000557300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ORELLANA-MEDINA KATHERINE L | Manager | 9773 W SAMPLE RD, CORAL SPRINGS, FL, 33065 |
| Medina Xaviefr | Manager | 9773 W. SAMPLE ROAD, CORAL SPRINGS, FL, 33065 |
| ORELLANA-MEDINA KATHERINE L | Agent | 9773 W SAMPLE RD, CORAL SPRINGS, FL, 33065 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000079494 | VISION SOURCE CORAL SPRINGS | EXPIRED | 2014-08-01 | 2019-12-31 | - | 9773 W. SAMPLE RD, CORAL SPRINGS, FL, 33065 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC NAME CHANGE | 2013-06-10 | CORAL SPRINGS VISION CARE, PLLC | - |
| LC NAME CHANGE | 2012-10-22 | VISION SOURCE CORAL SPRINGS, PLLC | - |
| LC NAME CHANGE | 2012-10-09 | CORAL SPRINGS VISION SOURCE, PLLC | - |
| REGISTERED AGENT ADDRESS CHANGED | 2009-03-10 | 9773 W SAMPLE RD, CORAL SPRINGS, FL 33065 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-04 |
| ANNUAL REPORT | 2024-03-26 |
| ANNUAL REPORT | 2023-01-29 |
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-03-04 |
| ANNUAL REPORT | 2020-06-10 |
| ANNUAL REPORT | 2019-01-30 |
| ANNUAL REPORT | 2018-06-28 |
| ANNUAL REPORT | 2017-04-29 |
| ANNUAL REPORT | 2016-04-17 |
Date of last update: 02 May 2025
Sources: Florida Department of State
