| Entity Name: | DR PAULINE L NGUYEN, O.D. & ASSOCIATES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 05 Feb 2008 (17 years ago) |
| Document Number: | P08000013256 |
| FEI/EIN Number | 680672325 |
| Address: | 11602 LAKE UNDERHILL RD, SUITE 103, ORLANDO, FL, 32825, US |
| Mail Address: | 14886 HONEYCRISP LN, ORLANDO, FL, 32827, US |
| ZIP code: | 32825 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114190204 | 2008-04-09 | 2011-06-27 | 10040 SAVANNAH BLUFF LANE, ORLANDO, FL, 32829, US | 3020 LAMBERTON BLVD, SUITE 107, ORLANDO, FL, 32825, US | |||||||||||||||||||||||
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| Phone | +1 407-780-6546 |
Authorized person
| Name | DR. PAULINE LAM NGUYEN |
| Role | OPTOMETRIST |
| Phone | 4077806546 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC004095 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 621298100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NGUYEN PAULINE L | Agent | 14886 HONEYCRISP LN, ORLANDO, FL, 32827 |
| Name | Role | Address |
|---|---|---|
| NGUYEN PAULINE L | Director | 14886 HONEYCRISP LN, ORLANDO, FL, 32827 |
| Name | Role | Address |
|---|---|---|
| NGUYEN TROY | Manager | 14886 HONEYCRISP LN, ORLANDO, FL, 32827 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G09000179908 | VISION EYE GALLERY | ACTIVE | 2009-12-01 | 2029-12-31 | No data | 14886 HONEYCRISP LANE, UNIT #103, ORLANDO, FL, 32827 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2015-01-24 | 11602 LAKE UNDERHILL RD, SUITE 103, ORLANDO, FL 32825 | No data |
| CHANGE OF MAILING ADDRESS | 2014-01-10 | 11602 LAKE UNDERHILL RD, SUITE 103, ORLANDO, FL 32825 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-01-10 | 14886 HONEYCRISP LN, ORLANDO, FL 32827 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-05 |
| ANNUAL REPORT | 2023-03-06 |
| ANNUAL REPORT | 2022-03-15 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-02-01 |
| ANNUAL REPORT | 2019-01-24 |
| ANNUAL REPORT | 2018-02-21 |
| ANNUAL REPORT | 2017-01-06 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
