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CHAMPION EYE INC

Company Details

Entity Name: CHAMPION EYE INC
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 15 Jan 2021 (4 years ago)
Document Number: P21000007533
FEI/EIN Number 86-1834638
Address: 6817 SOUTHPOINT PKWY, JACKSONVILLE, FL, 32216, US
Mail Address: 1016 Ponte Vedra Blvd, PONTE VEDRA BEACH, FL, 32082, US
ZIP code: 32216
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1568056026 2021-02-25 2021-10-22 6817 SOUTHPOINT PKWY STE 1503, JACKSONVILLE, FL, 322166298, US 6817 SOUTHPOINT PKWY STE 1503, JACKSONVILLE, FL, 322166298, US

Contacts

Phone +1 904-903-4068
Fax 9049005347

Authorized person

Name LENKA S CHAMPION
Role OWNER
Phone 9049034068

Taxonomy

Taxonomy Code 207W00000X - Ophthalmology Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CHAMPION EYE, INC. CASH BALANCE PLAN 2023 861834638 2024-07-10 CHAMPION EYE, INC. 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2022-01-01
Business code 621320
Sponsor’s telephone number 9047160530
Plan sponsor’s address 6817 SOUTHPOINT PARKWAY SUITE 1503, JACKSONVILLE, FL, 32216

Signature of

Role Plan administrator
Date 2024-07-10
Name of individual signing LENKA CHAMPION
Valid signature Filed with authorized/valid electronic signature
CHAMPION EYE INC 401(K) PLAN 2023 861834638 2024-05-29 CHAMPION EYE INC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-08-23
Business code 621111
Sponsor’s telephone number 9047160530
Plan sponsor’s address 6817 SOUTHPOINT PARKWAY, SUITE 1503, JACKSONVILLE, FL, 32216

Signature of

Role Plan administrator
Date 2024-05-29
Name of individual signing LENKA CHAMPION
Valid signature Filed with authorized/valid electronic signature
CHAMPION EYE INC 401(K) PLAN 2022 861834638 2023-06-06 CHAMPION EYE INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-08-23
Business code 621111
Sponsor’s telephone number 9047160530
Plan sponsor’s address 6817 SOUTHPOINT PARKWAY, SUITE 1503, JACKSONVILLE, FL, 32216

Signature of

Role Plan administrator
Date 2023-06-06
Name of individual signing LENKA CHAMPION
Valid signature Filed with authorized/valid electronic signature
CHAMPION EYE, INC. CASH BALANCE PLAN 2022 861834638 2024-07-10 CHAMPION EYE, INC. 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2022-01-01
Business code 621320
Sponsor’s telephone number 9047160530
Plan sponsor’s address 6817 SOUTHPOINT PARKWAY SUITE 1503, JACKSONVILLE, FL, 32216

Signature of

Role Plan administrator
Date 2024-07-10
Name of individual signing LENKA CHAMPION
Valid signature Filed with authorized/valid electronic signature
CHAMPION EYE, INC. CASH BALANCE PLAN 2022 861834638 2023-10-11 CHAMPION EYE, INC. 0
Three-digit plan number (PN) 002
Effective date of plan 2022-01-01
Business code 621320
Sponsor’s telephone number 9047160530
Plan sponsor’s address 6817 SOUTHPOINT PARKWAY SUITE 1503, JACKSONVILLE, FL, 32216

Agent

Name Role Address
CHAMPION LENKA S Agent 1016 PONTE VEDRA BLVD, PONTE VEDRA BEACH, FL, 32082

President

Name Role Address
CHAMPION LENKA S President 1016 PONTE VEDRA BLVD, PONTE VEDRA BEACH, FL, 32082

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G22000051156 CHAMPION EYECARE ACTIVE 2022-04-22 2027-12-31 No data 6817 SOUTHPOINT PKWY UNIT 1503, JACKSONVILLE, FL, 32216

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2021-08-25 6817 SOUTHPOINT PKWY, #1503, JACKSONVILLE, FL 32216 No data
CHANGE OF PRINCIPAL ADDRESS 2021-07-21 6817 SOUTHPOINT PKWY, #1503, JACKSONVILLE, FL 32216 No data

Documents

Name Date
ANNUAL REPORT 2024-04-02
ANNUAL REPORT 2023-01-27
ANNUAL REPORT 2022-03-11
Domestic Profit 2021-01-15

Date of last update: 01 Feb 2025

Sources: Florida Department of State