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RUSSELL STACKHOUSE, M.D., P.A. - Florida Company Profile

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Company Details

Entity Name: RUSSELL STACKHOUSE, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

RUSSELL STACKHOUSE, M.D., P.A. 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: 05 Jun 2018 (7 years ago)
Document Number: P18000050392
FEI/EIN Number 83-0953140

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 6 S 14th Street, FERNANDINA BEACH, FL, 32034, US
Mail Address: 6 S 14th Street, FERNANDINA BEACH, FL, 32034, US
ZIP code: 32034
City: Fernandina Beach
County: Nassau
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
STACKHOUSE RUSSELL M.D. Director 6 S 14th Street, FERNANDINA BEACH, FL, 32034
STACKHOUSE RUSSELL M.D. Agent 6 S 14th Street, FERNANDINA BEACH, FL, 32034

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
CWZXCK5LTTJ7
UEI Expiration Date:
2025-01-24

Business Information

Activation Date:
2024-01-29
Initial Registration Date:
2024-01-25

National Provider Identifier

NPI Number:
1538655014
Certification Date:
2022-12-13

Authorized Person:

Name:
NICHOLE RENE BARNETT
Role:
PRACTICE ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
207XX0004X - Orthopaedic Foot and Ankle Surgery Physician
Is Primary:
No
Selected Taxonomy:
207W00000X - Ophthalmology Physician
Is Primary:
Yes

Contacts:

Fax:
9042617383

Form 5500 Series

Employer Identification Number (EIN):
830953140
Plan Year:
2023
Number Of Participants:
84
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
83
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
52
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
34
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
21
Sponsors Telephone Number:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G18000131846 COASTAL VISION CENTER ACTIVE 2018-12-13 2028-12-31 - 6 S 14TH STREET, FERNANDINA BEACH, FL, 32034

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2019-04-25 6 S 14th Street, FERNANDINA BEACH, FL 32034 -
CHANGE OF MAILING ADDRESS 2019-04-25 6 S 14th Street, FERNANDINA BEACH, FL 32034 -
REGISTERED AGENT ADDRESS CHANGED 2019-04-25 6 S 14th Street, FERNANDINA BEACH, FL 32034 -

Documents

Name Date
ANNUAL REPORT 2025-01-23
ANNUAL REPORT 2024-02-02
ANNUAL REPORT 2023-01-19
ANNUAL REPORT 2022-02-10
ANNUAL REPORT 2021-02-02
ANNUAL REPORT 2020-03-03
ANNUAL REPORT 2019-04-25
Domestic Profit 2018-06-05

USAspending Awards / Financial Assistance

Date:
2024-09-04
Awarding Agency Name:
Department of Agriculture
Transaction Description:
REAP RENEWABLE ENERGY SYSTEM (RES) GRANT UNRESTRICTED AMOUNT
Obligated Amount:
74417.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2021-01-29
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
367900.00
Total Face Value Of Loan:
367900.00
Date:
2020-04-16
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
288100.00
Total Face Value Of Loan:
288100.00

Trademarks

Serial Number:
98350197
Mark:
COASTAL VISION CENTER
Status:
REGISTERED
Mark Type:
SERVICE MARK
Application Filing Date:
2024-01-10
Mark Drawing Type:
Standard character mark
Mark Literal Elements:
COASTAL VISION CENTER

Goods And Services

For:
Laser vision correction services; Laser vision surgery services; Ophthalmology services; Optometric services; Optometry services
First Use:
1981-01-01
International Classes:
044 - Primary Class
Class Status:
Active

Paycheck Protection Program

Jobs Reported:
33
Initial Approval Amount:
$367,900
Date Approved:
2021-01-29
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$367,900
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$370,823.04
Servicing Lender:
First-Citizens Bank & Trust Company
Use of Proceeds:
Payroll: $367,895
Utilities: $1
Jobs Reported:
33
Initial Approval Amount:
$288,100
Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$288,100
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$291,020.47
Servicing Lender:
First-Citizens Bank & Trust Company
Use of Proceeds:
Payroll: $288,100

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Date of last update: 01 Jul 2025

Sources: Florida Department of State