| Entity Name: | EN-VISION HEALTH SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Jul 2013 (12 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 08 Oct 2019 (5 years ago) |
| Document Number: | L13000102348 |
| FEI/EIN Number | 46-3228271 |
| Address: | 11349 BIG BEND ROAD, RIVERVIEW, FL, 33579, US |
| Mail Address: | 11349 BIG BEND ROAD, RIVERVIEW, FL, 33579, US |
| ZIP code: | 33579 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154750479 | 2013-11-06 | 2015-07-31 | 11349 BIG BEND RD, RIVERVIEW, FL, 335797183, US | 11349 BIG BEND RD, RIVERVIEW, FL, 335797183, US | |||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 813-672-8889 |
Authorized person
| Name | MISS MADHUMATHI PULLELA |
| Role | OWNER |
| Phone | 8137845590 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH27174 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH27174 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| License Number | PH27174 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| License Number | PH27174 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | STATE LICENSE |
| Number | PH27174 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PULLELA MADHUMATHI | Agent | 11349 BIG BEND ROAD, RIVERVIEW, FL, 33579 |
| Name | Role | Address |
|---|---|---|
| PULLELA MADHUMATHI | Auth | 11349 BIG BEND ROAD, RIVERVIEW, FL, 33579 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000072744 | HEALTHPRO PHARMACY | EXPIRED | 2013-07-19 | 2018-12-31 | No data | 20052 HERITAGE POINT DR, TAMPA, FL, 33647 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2019-10-08 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-10-08 | PULLELA, MADHUMATHI | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2016-04-09 | 11349 BIG BEND ROAD, RIVERVIEW, FL 33579 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-04-09 | 11349 BIG BEND ROAD, RIVERVIEW, FL 33579 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-02 |
| ANNUAL REPORT | 2023-02-23 |
| ANNUAL REPORT | 2022-03-06 |
| ANNUAL REPORT | 2021-03-12 |
| ANNUAL REPORT | 2020-06-07 |
| REINSTATEMENT | 2019-10-08 |
| ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-04-09 |
| ANNUAL REPORT | 2015-04-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
