| Entity Name: | WALESBY VISION CENTER, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 11 May 2001 (24 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 30 Apr 2021 (4 years ago) |
| Document Number: | P01000049393 |
| FEI/EIN Number | 593721846 |
| Address: | 24444 STATE ROAD 54, LUTZ, FL, 33559, US |
| Mail Address: | 24444 STATE ROAD 54, LUTZ, FL, 33559, US |
| ZIP code: | 33559 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265719066 | 2011-11-08 | 2012-01-26 | 2510 W WATERS AVE, TAMPA, FL, 336141833, US | 2510 W WATERS AVE, TAMPA, FL, 336141833, US | |||||||||||||||||||||
|
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| Phone | +1 813-915-0755 |
| Fax | 8139150704 |
Authorized person
| Name | DR. JOHN ROBERT WALESBY JR. |
| Role | PRESIDENT |
| Phone | 8139150755 |
Taxonomy
| Taxonomy Code | 332H00000X - Eyewear Supplier |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 084909000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| THOMAS NICHOLAS P | Agent | 24444 STATE ROAD 54, LUTZ, FL, 33559 |
| Name | Role | Address |
|---|---|---|
| THOMAS NICHOLAS P | President | 24444 STATE ROAD 54, LUTZ, FL, 33559 |
| Name | Role | Address |
|---|---|---|
| THOMAS NICHOLAS P | Director | 24444 STATE ROAD 54, LUTZ, FL, 33559 |
| Name | Role | Address |
|---|---|---|
| THOMAS NICHOLAS P | Treasurer | 24444 STATE ROAD 54, LUTZ, FL, 33559 |
| Name | Role | Address |
|---|---|---|
| THOMAS KIMBERLEE S | Secretary | 24444 STATE ROAD 54, LUTZ, FL, 33559 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2021-04-30 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-30 | 24444 STATE ROAD 54, LUTZ, FL 33559 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-30 | 24444 STATE ROAD 54, LUTZ, FL 33559 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-04-30 | THOMAS, NICHOLAS P | No data |
| AMENDMENT | 2008-12-15 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-26 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-01-14 |
| Amendment | 2021-04-30 |
| ANNUAL REPORT | 2021-03-06 |
| ANNUAL REPORT | 2020-01-22 |
| ANNUAL REPORT | 2019-05-07 |
| ANNUAL REPORT | 2018-02-05 |
| ANNUAL REPORT | 2017-03-13 |
| ANNUAL REPORT | 2016-03-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
