| Entity Name: | FLORIDA PEDIATRIC EYE SPECIALISTS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
FLORIDA PEDIATRIC EYE SPECIALISTS, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 19 Jul 2012 (13 years ago) |
| Last Event: | AMENDED AND RESTATEDARTICLES/NAME CHANGE |
| Event Date Filed: | 15 Sep 2020 (5 years ago) |
| Document Number: | P12000064119 |
| FEI/EIN Number |
36-4739430
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | PO BOX 2677, BRANDON, FL, 33509, US |
| Address: | 403 VONDERBURG DRIVE, BRANDON, FL, 33511, US |
| ZIP code: | 33511 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770837874 | 2012-10-29 | 2021-08-10 | 403 VONDERBURG DR, BRANDON, FL, 335115982, US | 3115 W SWANN AVE, TAMPA, FL, 336094617, US | |||||||||||||||||||||||||||||||
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| Phone | +1 813-681-1122 |
| Fax | 8136844924 |
| Phone | +1 813-879-7711 |
Authorized person
| Name | MR. GREGORY L HENDERSON SR. |
| Role | PRESIDENT |
| Phone | 8136811122 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | No |
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| Is Primary | Yes |
| Taxonomy Code | 207WX0110X - Pediatric Ophthalmology and Strabismus Specialist Physician Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 0537934-00 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HENDERSON GREGORY LM.D. | President | 403 VONDERBURG DRIVE, BRANDON, FL, 33511 |
| HENDERSON GREGORY LM.D. | Director | 403 VONDERBURG DRIVE, BRANDON, FL, 33511 |
| Hauser Brian | Chief Executive Officer | 403 VONDERBURG DRIVE, BRANDON, FL, 33511 |
| Brisch Christopher | Chief Financial Officer | 403 VONDERBURG DRIVE, BRANDON, FL, 33511 |
| HENDERSON GREGORY LM.D. | Agent | 403 VONDERBURG DRIVE, BRANDON, FL, 33511 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000104006 | GUGGINO EYE | EXPIRED | 2019-09-23 | 2024-12-31 | - | 3109 W. SWANN AVENUE, TAMPA, FL, 33609 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-22 | 403 VONDERBURG DRIVE, BRANDON, FL 33511 | - |
| CHANGE OF MAILING ADDRESS | 2021-04-22 | 403 VONDERBURG DRIVE, BRANDON, FL 33511 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-22 | 403 VONDERBURG DRIVE, BRANDON, FL 33511 | - |
| AMENDED AND RESTATEDARTICLES/NAME CHANGE | 2020-09-15 | FLORIDA PEDIATRIC EYE SPECIALISTS, INC. | - |
| REGISTERED AGENT NAME CHANGED | 2020-09-15 | HENDERSON, GREGORY L, M.D. | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-20 |
| ANNUAL REPORT | 2023-07-12 |
| ANNUAL REPORT | 2022-04-12 |
| ANNUAL REPORT | 2021-04-22 |
| Amended/Restated Article/NC | 2020-09-15 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-03-30 |
| ANNUAL REPORT | 2017-01-12 |
| ANNUAL REPORT | 2016-03-11 |
Date of last update: 03 Mar 2025
Sources: Florida Department of State
