| Entity Name: | GEORGE L. VAZOULAS, O.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 22 Feb 1993 (32 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | P93000015275 |
| FEI/EIN Number | 59-3165481 |
| Address: | 3921 SW COLLEGE RD, OCALA, FL 34474 |
| Mail Address: | 24 WINTERGREEN WAY, OCALA, FL 34482 |
| ZIP code: | 34474 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588801880 | 2009-01-08 | 2009-07-17 | 3100 SW COLLEGE RD, OCALA, FL, 344744419, US | 3100 SW COLLEGE RD, OCALA, FL, 344744419, US | |||||||||||||||||||||||||||
|
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| Phone | +1 352-237-7001 |
Authorized person
| Name | GEORGE VAZOULAS |
| Role | OWNER |
| Phone | 3528172625 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC 2634 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PTAN |
| Number | BD727 |
| Issuer | MEDICAID |
| Number | 07984400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GEORGE L. VAZOULAS, O.D. | Agent | 24 WINTERGREEN WAY, OCALA, FL 34482 |
| Name | Role | Address |
|---|---|---|
| VAZOULAS, GEORGE L. | President | 24 WINTERGREEN WAY, OCALA, FL 34482 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-08 | 3921 SW COLLEGE RD, OCALA, FL 34474 | No data |
| CHANGE OF MAILING ADDRESS | 2012-01-06 | 3921 SW COLLEGE RD, OCALA, FL 34474 | No data |
| REGISTERED AGENT NAME CHANGED | 2005-03-09 | GEORGE L. VAZOULAS, O.D. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2003-04-14 | 24 WINTERGREEN WAY, OCALA, FL 34482 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-02-14 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-01-19 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-01-13 |
| ANNUAL REPORT | 2017-01-07 |
| ANNUAL REPORT | 2016-01-24 |
| ANNUAL REPORT | 2015-01-12 |
| ANNUAL REPORT | 2014-01-21 |
| ANNUAL REPORT | 2013-01-27 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
