| Entity Name: | WESTON LASER & VISION INSTITUTE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
WESTON LASER & VISION INSTITUTE, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| 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: | 28 Aug 2000 (25 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 10 Nov 2003 (21 years ago) |
| Document Number: | P00000082606 |
| FEI/EIN Number |
651036262
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 2625 EXECUTIVE PARK DRIVE, STE 4, WESTON, FL, 33331 |
| Mail Address: | 2625 EXECUTIVE PARK DRIVE, STE 4, WESTON, FL, 33331 |
| ZIP code: | 33331 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568642676 | 2007-11-06 | 2024-04-29 | 2625 EXECUTIVE PARK DR, SUITE 4, WESTON, FL, 333313634, US | 2625 EXECUTIVE PARK DR, SUITE 4, WESTON, FL, 333313634, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-659-9051 |
| Fax | 9546599052 |
Authorized person
| Name | DR. SRINIVAS MUTYALA |
| Role | MEDICAL DIRECTOR |
| Phone | 9546599051 |
Taxonomy
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| License Number | ME0076746 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000408901 |
| State | FL |
| Issuer | MEDICAID |
| Number | 000408900 |
| State | FL |
| Issuer | MEDICAID |
| Number | 000408902 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MUTYALA SRINI | President | 2625 EXECUTIVE PARK DR #4, WESTON, FL, 33331 |
| MUTYALA SRINI | Agent | 2625 EXECUTIVE PARK DR, FORT LAUDERDALE, FL, 33331 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000149739 | WESTON/PANNU LASER VISION INSTITUTE | ACTIVE | 2020-11-22 | 2025-12-31 | - | 2625 EXECUTIVE PARK DR #4, WESTON, FL, 33331 |
| G09006900854 | WESTON/PANNU LASER VISION INSTITUTE | EXPIRED | 2009-01-05 | 2014-12-31 | - | 2625 EXECUTIVE PARK DR #4, WESTON, FL, 33331 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2008-02-21 | MUTYALA, SRINI | - |
| REGISTERED AGENT ADDRESS CHANGED | 2008-02-21 | 2625 EXECUTIVE PARK DR, SUITE #4, FORT LAUDERDALE, FL 33331 | - |
| CANCEL ADM DISS/REV | 2003-11-10 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2001-07-18 | 2625 EXECUTIVE PARK DRIVE, STE 4, WESTON, FL 33331 | - |
| CHANGE OF MAILING ADDRESS | 2001-07-18 | 2625 EXECUTIVE PARK DRIVE, STE 4, WESTON, FL 33331 | - |
| NAME CHANGE AMENDMENT | 2001-04-23 | WESTON LASER & VISION INSTITUTE, INC. | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-13 |
| ANNUAL REPORT | 2023-02-27 |
| ANNUAL REPORT | 2022-01-29 |
| ANNUAL REPORT | 2021-01-30 |
| ANNUAL REPORT | 2020-01-19 |
| ANNUAL REPORT | 2019-02-04 |
| ANNUAL REPORT | 2018-01-21 |
| ANNUAL REPORT | 2017-02-08 |
| ANNUAL REPORT | 2016-01-15 |
| ANNUAL REPORT | 2015-01-12 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3297647100 | 2020-04-11 | 0455 | PPP | 2625 Executive Park Dr #4, FORT LAUDERDALE, FL, 33331-3624 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3239108405 | 2021-02-04 | 0455 | PPS | 2625 Executive Park Dr Ste 4, Weston, FL, 33331-3634 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Mar 2025
Sources: Florida Department of State
