| Entity Name: | TOTAL VISION OF PALM COAST, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 12 Dec 2002 (22 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 24 Feb 2015 (10 years ago) |
| Document Number: | P02000131228 |
| FEI/EIN Number | 562312623 |
| Address: | 15 CYPRESS BRANCH WAY, STE. 205, PALM COAST, FL, 32137 |
| Mail Address: | 15 CYPRESS BRANCH WAY, STE. 205, PALM COAST, FL, 32137 |
| ZIP code: | 32137 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972707958 | 2007-06-13 | 2008-07-24 | 15 CYPRESS BRANCH WAY, SUITE #205, PALM COAST, FL, 321648413, US | 15 CYPRESS BRANCH WAY, SUITE #205, PALM COAST, FL, 321648413, US | |||||||||||||||||||||||||
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| Phone | +1 386-445-1880 |
| Fax | 3864458796 |
Authorized person
| Name | DR. PHILLIP LEE STEPHENS |
| Role | OWNER |
| Phone | 3864451880 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC 0002395 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 078287400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| STEPHENS PHILLIP L | Agent | 15 CYPRESS BRANCH WAY STE 206, PALM COAST, FL, 32137 |
| Name | Role | Address |
|---|---|---|
| CADY MICHAEL T | Director | 524 CANAL ST., NEW SMYRNA BEACH, FL, 32168 |
| STEPHENS PHILLIP L | Director | 524 CANAL ST., NEW SMYRNA BEACH, FL, 32168 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2015-02-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2015-02-24 | STEPHENS, PHILLIP L | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-06-03 | 15 CYPRESS BRANCH WAY, STE. 205, PALM COAST, FL 32137 | No data |
| CHANGE OF MAILING ADDRESS | 2005-06-03 | 15 CYPRESS BRANCH WAY, STE. 205, PALM COAST, FL 32137 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2004-04-28 | 15 CYPRESS BRANCH WAY STE 206, PALM COAST, FL 32137 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13001684415 | LAPSED | 2013-CC-321 | CTY FLAGLER COUNTY FL | 2013-11-12 | 2018-12-02 | $4,565.12 | JOHNSON & JOHNSON VISION CARE, INC., F/K/A VISTAKON, INC., 7500 CENTURION PARKWAY, JACKSONVILLE, FL 32256 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-03-29 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-03-23 |
| ANNUAL REPORT | 2020-07-07 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-04-20 |
| ANNUAL REPORT | 2016-05-01 |
| REINSTATEMENT | 2015-02-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
