| Entity Name: | FORT PIERCE VISION LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
FORT PIERCE VISION LLC 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: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 15 Sep 2015 (10 years ago) |
| Date of dissolution: | 22 Sep 2017 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (8 years ago) |
| Document Number: | L15000153859 |
| FEI/EIN Number |
47-5070367
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 5100 OKEECHOBEE ROAD, FT. PIERCE, FL, 34947, US |
| Mail Address: | 5100 OKEECHOBEE ROAD, FT. PIERCE, FL, 34947, US |
| ZIP code: | 34947 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144699042 | 2015-09-21 | 2015-09-21 | 5100 OKEECHOBEE RD, FORT PIERCE, FL, 349475428, US | 5100 OKEECHOBEE RD, FORT PIERCE, FL, 349475428, US | |||||||||||||||||||||||||
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| Phone | +1 954-821-1111 |
| Fax | 7723369017 |
Authorized person
| Name | DR. PHILIP C DESANTIS |
| Role | MANAGER |
| Phone | 9548211111 |
Taxonomy
| Taxonomy Code | 302R00000X - Health Maintenance Organization |
| License Number | OPC2169 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 010527400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DESANTIS PHILIP C | Authorized Member | 5100 OKEECHOBEE ROAD, FT. PIERCE, FL, 34947 |
| DESANTIS PAUL | Authorized Member | 5100 OKEECHOBEE ROAD, FT. PIERCE, FL, 34947 |
| DESANTIS PHILIP C | Agent | 341 SE 6TH AVENUE, POMPANO BEACH, FL, 33060 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-04-29 |
| Florida Limited Liability | 2015-09-15 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
