| Entity Name: | BROOME VISION, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 08 Jan 2008 (17 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 24 Oct 2011 (13 years ago) |
| Document Number: | P08000002319 |
| FEI/EIN Number | 261693327 |
| Address: | 701 S. RIDGEWOOD AVE., DAYTONA BEACH, FL, 32114 |
| Mail Address: | 701 S. RIDGEWOOD AVE., DAYTONA BEACH, FL, 32114 |
| ZIP code: | 32114 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407010119 | 2008-07-11 | 2011-02-25 | 2564 ENTERPRISE RD, ORANGE CITY, FL, 327637904, US | 2564 ENTERPRISE RD, ORANGE CITY, FL, 327637904, US | |||||||||||||||||||||||||
|
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| Phone | +1 386-774-7242 |
| Fax | 3867748442 |
Authorized person
| Name | KEVIN ANDREW BROOME |
| Role | PRESIDENT/OWNER |
| Phone | 3862535999 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC3301 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000206401 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BROOME KEVIN A | Agent | 701 S RIDGEWOOD AVE, DAYTONA BEACH, FL, 32114 |
| Name | Role | Address |
|---|---|---|
| BROOME KEVIN A | Managing Member | 701 S. RIDGEWOOD AVE., DAYTONA BEACH, FL, 32114 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000143071 | DAYTONA EYE CENTER | ACTIVE | 2017-12-29 | 2027-12-31 | No data | 701 S RIDGEWOOD AVE, DAYTONA BEACH, FL, 32114 |
| G17000143075 | EYESAVERS | ACTIVE | 2017-12-29 | 2027-12-31 | No data | 701 S RIDGEWOOD AVE, DAYTONA BEACH, FL, 32114 |
| G08114900208 | DAYTONA EYE CENTER | EXPIRED | 2008-04-23 | 2013-12-31 | No data | PO BOX 351, DAYTONA BEACH, FL, 32115 |
| G08114900196 | EYESAVERS | EXPIRED | 2008-04-23 | 2013-12-31 | No data | 3781 O S. NOVA ROAD, PORT ORANGE, FL, 32129 |
| G08114900197 | EYESAVERS | EXPIRED | 2008-04-23 | 2013-12-31 | No data | 2564 ENTERPRISE ROAD, ORANGE CITY, FL, 32763 |
| G08116900055 | EYESAVERS | EXPIRED | 2008-04-23 | 2013-12-31 | No data | 1474 W. GRANADA BLVD, ORMOND BEACH, FL, 32174 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2011-10-24 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-10-24 | 701 S RIDGEWOOD AVE, DAYTONA BEACH, FL 32114 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2009-04-23 | BROOME, KEVIN A | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-09 |
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-28 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-03-13 |
| ANNUAL REPORT | 2019-03-25 |
| ANNUAL REPORT | 2018-03-16 |
| ANNUAL REPORT | 2017-03-30 |
| ANNUAL REPORT | 2016-03-18 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
