| Entity Name: | CHARLES NUNEZ, OD, & ASSOCIATES, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 18 Jun 2012 (13 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P12000054714 |
| FEI/EIN Number | 45-5525928 |
| Address: | 88 Old Wiggins lane, Ormond beach, FL 32174 |
| Mail Address: | 88 Old Wiggins lane, Ormond beach, FL 32174 |
| ZIP code: | 32174 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174040083 | 2017-08-23 | 2017-08-23 | 25 W COLLEGE AVE STE D, RUSKIN, FL, 335704701, US | 25 W COLLEGE AVE STE D, RUSKIN, FL, 335704701, US | |||||||||||||||||||||
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| Phone | +1 813-886-2020 |
| Fax | 8558241872 |
Authorized person
| Name | CHARLES NUNEZ |
| Role | OPTOMETRIST/OWNER |
| Phone | 8138862020 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 010539500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NUNEZ, CHARLES | Agent | 88 Old Wiggins lane, Ormond beach, FL 32174 |
| Name | Role | Address |
|---|---|---|
| NUNEZ, CHARLES | President | 88 Old Wiggins lane, Ormond beach, FL 32174 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-12 | 88 Old Wiggins lane, Ormond beach, FL 32174 | No data |
| CHANGE OF MAILING ADDRESS | 2018-04-12 | 88 Old Wiggins lane, Ormond beach, FL 32174 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-12 | 88 Old Wiggins lane, Ormond beach, FL 32174 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-06-16 | NUNEZ, CHARLES | No data |
| REINSTATEMENT | 2017-06-16 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-04-12 |
| REINSTATEMENT | 2017-06-16 |
| ANNUAL REPORT | 2014-04-24 |
| ANNUAL REPORT | 2013-04-15 |
| Domestic Profit | 2012-06-18 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
