| Entity Name: | VIP EYE CARE & EYE WEAR, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 11 Dec 2006 (18 years ago) |
| Document Number: | P06000151673 |
| FEI/EIN Number | 208018061 |
| Address: | 2201 4TH STREET N., STE. A, SAINT PETERSBURG, FL, 33704, US |
| Mail Address: | 2201 4th Street North Suite A, ST. PETERSBURG, FL, 33704, US |
| ZIP code: | 33704 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336575554 | 2013-09-19 | 2024-01-31 | 2201 4TH ST N STE A, SAINT PETERSBURG, FL, 337044300, US | 2201 4TH ST N STE A, SAINT PETERSBURG, FL, 337044300, US | |||||||||||||||||||||||||
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| Phone | +1 727-894-0500 |
| Fax | 7278238697 |
Authorized person
| Name | DR. MONA A HENRI |
| Role | OWNER |
| Phone | 7278940500 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC0002526 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 078852000 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VIP EYE CARE & EYE WEAR INC. 401(K) PLAN | 2018 | 208018061 | 2019-05-07 | VIP EYE CARE & EYE WEAR INC. | 9 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2019-05-07 |
| Name of individual signing | MONA A. HENRI |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2019-05-07 |
| Name of individual signing | MONA A. HENRI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2017-01-01 |
| Business code | 621320 |
| Sponsor’s telephone number | 7278940500 |
| Plan sponsor’s address | 2201 4TH STREET NORTH, SUITE A, ST. PETERSBURG, FL, 33704 |
Signature of
| Role | Plan administrator |
| Date | 2018-06-25 |
| Name of individual signing | MONA A. HENRI |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| HENRI MONA A | Agent | 2201 4th Street North, ST PETERSBURG, FL, 33704 |
| Name | Role | Address |
|---|---|---|
| HENRI MONA A | President | 2201 4th Street N. Suite A, ST PETERSBURG, FL, 33704 |
| Name | Role | Address |
|---|---|---|
| SEVASTAKIS ARETTA | Vice President | 2201 4TH STREET N. STE A, ST PETERSBURG, FL, 33704 |
| Name | Role | Address |
|---|---|---|
| HENRI MONA A | Secretary | 2201 4th Street North Suite A, ST PETERSBURG, FL, 33704 |
| Name | Role | Address |
|---|---|---|
| SEVASTAKIS ARETTA | Treasurer | 2201 4TH STREET N. STE A, ST PETERSBURG, FL, 33704 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G07214900246 | VIP EYE CARE AND EYE WEAR | ACTIVE | 2007-08-02 | 2027-12-31 | No data | 2201 4TH STREET N., SUITE A, ST PETERSBURG, FL, 33704 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2016-01-15 | 2201 4th Street North, ST PETERSBURG, FL 33704 | No data |
| CHANGE OF MAILING ADDRESS | 2014-02-27 | 2201 4TH STREET N., STE. A, SAINT PETERSBURG, FL 33704 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-09-21 | 2201 4TH STREET N., STE. A, SAINT PETERSBURG, FL 33704 | No data |
| REGISTERED AGENT NAME CHANGED | 2009-03-24 | HENRI, MONA AP | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-23 |
| ANNUAL REPORT | 2024-01-16 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-20 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-01-03 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-01-12 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-01-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
