| Entity Name: | DR. GRAY R. SMITH, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Dec 2002 (22 years ago) |
| Document Number: | P02000135163 |
| FEI/EIN Number | 900117879 |
| Address: | 2250 EAST HWY 50, SUITE 1, CLERMONT, FL, 34711 |
| Mail Address: | 2250 EAST HWY 50, SUITE 1, CLERMONT, FL, 34711 |
| ZIP code: | 34711 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588805444 | 2009-03-23 | 2012-03-06 | 2250 E HIGHWAY 50, SUITE 1, CLERMONT, FL, 347116052, US | 2250 E HIGHWAY 50, SUITE 1, CLERMONT, FL, 347116052, US | |||||||||||||||||||
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| Phone | +1 352-243-5348 |
| Fax | 3522438358 |
Authorized person
| Name | DR. GRAY ROBERT SMITH |
| Role | PRES |
| Phone | 3522435349 |
Taxonomy
| Taxonomy Code | 152WC0802X - Corneal and Contact Management Optometrist |
| License Number | OPC 3661 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR GRAY R SMITH INC 401(K) PROFIT SHARING PLAN & TRUST | 2023 | 900117879 | 2024-07-31 | DR GRAY R SMITH INC | 4 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-31 |
| Name of individual signing | GRAY SMITH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 621320 |
| Sponsor’s telephone number | 3522435349 |
| Plan sponsor’s address | 2250 EAST HWY 50 SUITE 1, CLERMONT, FL, 34711 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-13 |
| Name of individual signing | GRAY SMITH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 621320 |
| Sponsor’s telephone number | 3522435349 |
| Plan sponsor’s address | 2250 EAST HWY 50 SUITE 1, CLERMONT, FL, 34711 |
Signature of
| Role | Plan administrator |
| Date | 2022-10-04 |
| Name of individual signing | GRAY SMITH |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| SMITH GRAY R | Agent | 2250 EAST HWY 50, CLERMONT, FL, 34711 |
| Name | Role | Address |
|---|---|---|
| SMITH GRAY R | President | 2250 EAST HWY 50, STE 1, CLERMONT, FL, 34711 |
| Name | Role | Address |
|---|---|---|
| Baltodano Nohemy | Vice President | 2250 EAST HWY 50, CLERMONT, FL, 34711 |
| Name | Role | Address |
|---|---|---|
| Smith Islay | Secretary | 2250 EAST HWY 50, CLERMONT, FL, 34711 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000066847 | SOUTH LAKE OPTICAL | ACTIVE | 2022-05-31 | 2027-12-31 | No data | 2250 EAST HIGHWAY 50, SUITE 1, CLERMONT, FL, 34711 |
| G08193900059 | SOUTH LAKE OPTICAL | EXPIRED | 2008-07-09 | 2013-12-31 | No data | 2250 EAST HIGHWAY 50, SUITE 1, CLERMONT, FL, 34711 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-30 | 2250 EAST HWY 50, SUITE 1, CLERMONT, FL 34711 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-04-30 | 2250 EAST HWY 50, SUITE 1, CLERMONT, FL 34711 | No data |
| CHANGE OF MAILING ADDRESS | 2009-04-30 | 2250 EAST HWY 50, SUITE 1, CLERMONT, FL 34711 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-11-09 |
| ANNUAL REPORT | 2024-04-28 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-04-18 |
| ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2020-04-30 |
| ANNUAL REPORT | 2019-04-27 |
| ANNUAL REPORT | 2018-03-27 |
| ANNUAL REPORT | 2017-03-23 |
| ANNUAL REPORT | 2016-03-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
