| Entity Name: | VINCENT B. AZZUE, O.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 May 2002 (23 years ago) |
| Document Number: | P02000059407 |
| FEI/EIN Number | 300079534 |
| Address: | 8603 Easthaven Court, Suite 101, NEW PORT RICHEY, FL, 34655, US |
| Mail Address: | 8603 Easthaven Court, Suite 101, NEW PORT RICHEY, FL, 34655, US |
| ZIP code: | 34655 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285939728 | 2011-01-13 | 2011-01-13 | 8505 LITTLE RD, NEW PORT RICHEY, FL, 346544924, US | 8505 LITTLE RD, NEW PORT RICHEY, FL, 346544924, US | |||||||||||||||||||||||||
|
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| Phone | +1 727-844-3223 |
| Fax | 7278443201 |
Authorized person
| Name | DR. VINCENT BARTH AZZUE |
| Role | OWNER |
| Phone | 7278443223 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC 2877 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 620149100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| AZZUE VINCENT B | Agent | 6325 Garland Court, NEW PORT RICHEY, FL, 34652 |
| Name | Role | Address |
|---|---|---|
| AZZUE VINCENT BDr. | Director | 6325 Garland Court, NEW PORT RICHEY, FL, 34652 |
| Name | Role | Address |
|---|---|---|
| AZZUE VINCENT BDr. | President | 6325 Garland Court, NEW PORT RICHEY, FL, 34652 |
| Name | Role | Address |
|---|---|---|
| AZZUE VINCENT BDr. | Secretary | 6325 Garland Court, NEW PORT RICHEY, FL, 34652 |
| Name | Role | Address |
|---|---|---|
| AZZUE VINCENT BDr. | Treasurer | 6325 Garland Court, NEW PORT RICHEY, FL, 34652 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000107122 | AZZUE OPTOMETRY | ACTIVE | 2020-08-19 | 2025-12-31 | No data | 8603 EASTHAVEN COURT, NEW PORT RICHEY, FL, 34655 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2018-02-09 | 6325 Garland Court, NEW PORT RICHEY, FL 34652 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-02-09 | 8603 Easthaven Court, Suite 101, NEW PORT RICHEY, FL 34655 | No data |
| CHANGE OF MAILING ADDRESS | 2017-02-09 | 8603 Easthaven Court, Suite 101, NEW PORT RICHEY, FL 34655 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-26 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-02-03 |
| ANNUAL REPORT | 2021-02-13 |
| ANNUAL REPORT | 2020-01-29 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-02-09 |
| ANNUAL REPORT | 2017-02-09 |
| ANNUAL REPORT | 2016-03-10 |
| ANNUAL REPORT | 2015-04-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
