| Entity Name: | ROGER L. WILSON, O.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 25 Mar 1996 (29 years ago) |
| Document Number: | P96000026142 |
| FEI/EIN Number | 593367513 |
| Address: | 1515A Atlantic Blvd, Jacksonville, FL, 32207, US |
| Mail Address: | 121 Natures Way, PONTE VEDRA BEACH, FL, 32082, US |
| ZIP code: | 32207 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164699054 | 2008-05-11 | 2008-05-11 | 110 SOLANA RD, PONTE VEDRA BEACH, FL, 320822230, US | 110 SOLANA RD, PONTE VEDRA BEACH, FL, 320822230, US | |||||||||||||||||||
|
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| Phone | +1 904-280-2021 |
| Fax | 9042802024 |
Authorized person
| Name | DR. ROGER L. WILSON |
| Role | PRESIDENT |
| Phone | 9042802021 |
Taxonomy
| Taxonomy Code | 152WC0802X - Corneal and Contact Management Optometrist |
| License Number | OP2569 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Wilson Roger LDr. | Agent | 121 NATURES WAY, PONTE VEDRA BEACH, FL, 32082 |
| Name | Role | Address |
|---|---|---|
| WILSON ROGER L | President | 121 NATURES WAY, PONTE VEDRA BEACH, FL, 32082 |
| Name | Role | Address |
|---|---|---|
| WILSON ROGER L | Secretary | 121 NATURES WAY, PONTE VEDRA BEACH, FL, 32082 |
| Name | Role | Address |
|---|---|---|
| WILSON ROGER L | Treasurer | 121 NATURES WAY, PONTE VEDRA BEACH, FL, 32082 |
| Name | Role | Address |
|---|---|---|
| WILSON ROGER L | Director | 121 NATURES WAY, PONTE VEDRA BEACH, FL, 32082 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2019-04-15 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
