| Entity Name: | VAL-U-VISION OF BEAUCLERC-MANDARIN, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 24 May 1999 (26 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 21 Jun 1999 (26 years ago) |
| Document Number: | P99000048083 |
| FEI/EIN Number | 593587628 |
| Address: | 9397-2 SAN JOSE BLVD., JACKSONVILLE, FL, 32257 |
| Mail Address: | 9397-3 SAN JOSE BLVD, JACKSONVILLE, FL, 32257 |
| ZIP code: | 32257 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255361416 | 2006-07-04 | 2015-09-16 | 9397 SAN JOSE BLVD, #3, JACKSONVILLE, FL, 322575587, US | 9397 SAN JOSE BLVD, SUITE 2, JACKSONVILLE, FL, 322575587, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 904-730-2299 |
| Fax | 9047302557 |
Authorized person
| Name | DR. GAYLE P LEINWOHL |
| Role | PRESIDENT/ PHYSICIAN |
| Phone | 9047302299 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC 1046 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009899900 |
| State | FL |
| Issuer | BCBS |
| Number | 40529 |
| State | FL |
| Name | Role |
|---|---|
| D. R. REPASS, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| LEINWOHL GAYLE P | President | 9397-3 SAN JOSE BLVD., JACKSONVILLE, FL, 32257 |
| Name | Role | Address |
|---|---|---|
| LEINWOHL GAYLE P | Director | 9397-3 SAN JOSE BLVD., JACKSONVILLE, FL, 32257 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2016-01-25 | 111Solana Rd, SUITE B, Ponte Vedra Beach, FL 32082 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-01-29 | D. R. REPASS | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-03-23 | 9397-2 SAN JOSE BLVD., JACKSONVILLE, FL 32257 | No data |
| CHANGE OF MAILING ADDRESS | 2009-03-23 | 9397-2 SAN JOSE BLVD., JACKSONVILLE, FL 32257 | No data |
| NAME CHANGE AMENDMENT | 1999-06-21 | VAL-U-VISION OF BEAUCLERC-MANDARIN, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-14 |
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-02-06 |
| ANNUAL REPORT | 2019-03-19 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-01-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
