| Entity Name: | VIP AMERICA OF SOUTHWEST FLORIDA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 31 Mar 2009 (16 years ago) |
| Document Number: | L09000031164 |
| FEI/EIN Number | 264591501 |
| Address: | 14440 METROPOLIS AVE., SUITE 103, FORT MYERS, FL, 33912, US |
| Mail Address: | 14440 METROPOLIS AVE., SUITE 103, FORT MYERS, FL, 33912, US |
| ZIP code: | 33912 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104143486 | 2010-04-27 | 2024-10-16 | 2500 S KANNER HWY STE 3, STUART, FL, 349944600, US | 14440 METROPOLIS AVE STE 103, FORT MYERS, FL, 339124364, US | |||||||||||||||||||||||||
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| Phone | +1 772-220-6005 |
| Fax | 7722205867 |
| Phone | +1 239-690-9969 |
| Fax | 2396909971 |
Authorized person
| Name | ASHLEY SKIPPER |
| Role | VP OF OPERATIONS |
| Phone | 7722206005 |
Taxonomy
| Taxonomy Code | 3747A0650X - Attendant Care Provider |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 114309400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Turnbull Scott WEsq. | Agent | 759 SW Federal Hwy., Stuart, FL, 34994 |
| Name | Role | Address |
|---|---|---|
| VIP America, LLC | Manager | 2500 S. KANNER HWY., STUART, FL, 34994 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-06-06 | Turnbull, Scott W., Esq. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-06-06 | 759 SW Federal Hwy., Suite 106, Stuart, FL 34994 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-12-13 | 14440 METROPOLIS AVE., SUITE 103, FORT MYERS, FL 33912 | No data |
| CHANGE OF MAILING ADDRESS | 2017-12-13 | 14440 METROPOLIS AVE., SUITE 103, FORT MYERS, FL 33912 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-06-06 |
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-04-20 |
| ANNUAL REPORT | 2021-03-31 |
| ANNUAL REPORT | 2020-04-29 |
| ANNUAL REPORT | 2019-04-24 |
| ANNUAL REPORT | 2018-04-04 |
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-04-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
