| Entity Name: | THE VISION HUB, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 11 May 2021 (4 years ago) |
| Document Number: | L21000219031 |
| FEI/EIN Number | 86-3891336 |
| Address: | 113 NORTH PALAFOX STREET, PENSACOLA, FL, 32502, US |
| Mail Address: | 113 NORTH PALAFOX STREET, PENSACOLA, FL, 32502 |
| ZIP code: | 32502 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720652316 | 2021-05-18 | 2024-03-15 | 770 US HIGHWAY 331 S STE 1, DEFUNIAK SPRINGS, FL, 324353307, US | 770 US HIGHWAY 331 S STE 1, DEFUNIAK SPRINGS, FL, 324353307, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 850-892-5514 |
| Fax | 8502004373 |
| Fax | 8508920189 |
Authorized person
| Name | CHRISTAL ROCERETO |
| Role | CREDENTIALIST |
| Phone | 8505425133 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | Yes |
| Taxonomy Code | 152WC0802X - Corneal and Contact Management Optometrist |
| Is Primary | No |
| Taxonomy Code | 152WP0200X - Pediatric Optometrist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 111200300 |
| State | FL |
| Issuer | BCBS |
| Number | XB20D |
| Name | Role | Address |
|---|---|---|
| SPEAR KATIE | Agent | 113 NORTH PALAFOX STREET, PENSACOLA, FL, 32502 |
| Name | Role | Address |
|---|---|---|
| SPEAR KATIE | Authorized Member | 113 NORTH PALAFOX STREET, PENSACOLA, FL, 32502 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-04-05 |
| ANNUAL REPORT | 2022-04-30 |
| Florida Limited Liability | 2021-05-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
