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  5. WEST FLORIDA OPHTHALMOLOGY, INC.

WEST FLORIDA OPHTHALMOLOGY, INC.

Company Details

Entity Name: WEST FLORIDA OPHTHALMOLOGY, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 30 Sep 2005 (19 years ago)
Document Number: P05000135117
FEI/EIN Number 203683057
Mail Address: 2430 Estancia Boulevard, Suite 114, Clearwater, FL, 33761, US
Address: 3155 CURLEW RD, OLDSMAR, FL, 34677
ZIP code: 34677
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1104850122 2006-07-10 2018-06-21 3155 CURLEW RD, OLDSMAR, FL, 346772606, US 3155 CURLEW RD, OLDSMAR, FL, 346772606, US

Contacts
Phone +1 727-216-2020
Fax 7272161173

Authorized person
Name DR. LAURA T MULLER
Role PRESIDENT
Phone 7272162020

Taxonomy
Taxonomy Code 207W00000X - Ophthalmology Physician
Is Primary Yes
Taxonomy Code 332H00000X - Eyewear Supplier
Is Primary No

Other Provider Identifiers
Issuer MEDICARE DME PTAN
Number 6710800001
State FL
Issuer RAILROAD MEDICARE
Number DF5741
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WEST FLORIDA OPHTHALMOLOGY INC 401(K) PS PLAN 2023 203683057 2024-07-02 WEST FLORIDA OPHTHALMOLOGY, INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7272162020
Plan sponsor’s address 3155 CURLEW ROAD, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2024-07-02
Name of individual signing LAURA MULLER
Valid signature Filed with authorized/valid electronic signature
WEST FLORIDA OPHTHALMOLOGY INC 401(K) PS PLAN 2022 203683057 2023-06-29 WEST FLORIDA OPHTHALMOLOGY, INC. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7272162020
Plan sponsor’s address 3155 CURLEW ROAD, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2023-06-29
Name of individual signing LAURA MULLER
Valid signature Filed with authorized/valid electronic signature
WEST FLORIDA OPHTHALMOLOGY INC 401(K) PS PLAN 2021 203683057 2022-06-29 WEST FLORIDA OPHTHALMOLOGY, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7272162020
Plan sponsor’s address 3155 CURLEW ROAD, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2022-06-29
Name of individual signing SHERRI MANSURE
Valid signature Filed with authorized/valid electronic signature
WEST FLORIDA OPHTHALMOLOGY INC 401(K) PS PLAN 2020 203683057 2021-05-12 WEST FLORIDA OPHTHALMOLOGY, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7272162020
Plan sponsor’s address 3155 CURLEW ROAD, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2021-05-12
Name of individual signing SHERRI MANSURE
Valid signature Filed with authorized/valid electronic signature
WEST FLORIDA OPHTHALMOLOGY 401K P/S PLAN 2019 203683057 2020-02-27 WEST FLORIDA OPHTHALMOLOGY INC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7272162020
Plan sponsor’s address 3155 CURLEW ROAD, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2020-02-27
Name of individual signing LAURA MULLER
Valid signature Filed with authorized/valid electronic signature
WEST FLORIDA OPHTHALMOLOGY 401K P/S PLAN 2018 203683057 2019-04-01 WEST FLORIDA OPHTHALMOLOGY INC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7272162020
Plan sponsor’s address 3155 CURLEW ROAD, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2019-04-01
Name of individual signing LAURA MULLER
Valid signature Filed with authorized/valid electronic signature
WEST FLORIDA OPHTHALMOLOGY 401K P/S PLAN 2017 203683057 2018-06-07 WEST FLORIDA OPHTHALMOLOGY INC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7272162020
Plan sponsor’s address 3155 CURLEW ROAD, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2018-06-07
Name of individual signing LAURA MULLER
Valid signature Filed with authorized/valid electronic signature
WEST FLORIDA OPHTHALMOLOGY 401K P/S PLAN 2016 203683057 2017-07-11 WEST FLORIDA OPHTHALMOLOGY INC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7272162020
Plan sponsor’s address 3155 CURLEW ROAD, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2017-07-11
Name of individual signing LAURA MULLER
Valid signature Filed with authorized/valid electronic signature
WEST FLORIDA OPHTHALMOLOGY 401K P/S PLAN 2015 203683057 2016-02-02 WEST FLORIDA OPHTHALMOLOGY INC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7272162020
Plan sponsor’s address 3155 CURLEW ROAD, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2016-02-02
Name of individual signing LAURA MULLER
Valid signature Filed with authorized/valid electronic signature
WEST FLORIDA OPHTHALMOLOGY 401K P/S PLAN 2014 203683057 2015-11-20 WEST FLORIDA OPHTHALMOLOGY INC 19
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7272162020
Plan sponsor’s address 3155 CURLEW RD, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2015-11-20
Name of individual signing ARLENE TONJES
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
TRUSTEE AND CORPORATE SERVICES, INC. Agent

President

Name Role Address
MULLER LAURA President 3155 Curlew Road, Oldsmar, FL, 34677

Secretary

Name Role Address
MULLER LAURA Secretary 3155 Curlew Road, Oldsmar, FL, 34677

Treasurer

Name Role Address
MULLER LAURA Treasurer 3155 Curlew Road, Oldsmar, FL, 34677

Director

Name Role Address
MULLER LAURA Director 3155 Curlew Road, Oldsmar, FL, 34677

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2018-01-19 3155 CURLEW RD, OLDSMAR, FL 34677 No data
REGISTERED AGENT NAME CHANGED 2018-01-19 Trustee and Corporate Services, Inc. No data
REGISTERED AGENT ADDRESS CHANGED 2018-01-19 2430 Estancia Boulevard, Suite 114, Clearwater, FL 33761 No data
CHANGE OF PRINCIPAL ADDRESS 2012-08-14 3155 CURLEW RD, OLDSMAR, FL 34677 No data

Documents

Name Date
ANNUAL REPORT 2024-01-31
ANNUAL REPORT 2023-02-03
ANNUAL REPORT 2022-02-22
ANNUAL REPORT 2021-03-05
ANNUAL REPORT 2020-01-23
ANNUAL REPORT 2019-02-14
AMENDED ANNUAL REPORT 2018-01-19
ANNUAL REPORT 2018-01-17
ANNUAL REPORT 2017-01-06
ANNUAL REPORT 2016-04-06

Related by officers

MULLER LAURA

DELAG PROPERTIES L.L.C. BULLY STICK COMPANY LLC TWODIO LLC

Related by address

2430 Estancia Boulevard, Suite 114, Clearwater, FL, 33761, US

SP SPRINGWOOD GP INC. LTM EYE CENTER LLC SOUTHPORT FINANCIAL REAL ESTATE LLC RF COMPANY CPA'S, P.S., INC. EXECUTIVE PARK OF VALRICO OWNERS' ASSOCIATION, INC.

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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