| Entity Name: | ROBERTS OPTICAL CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 12 May 1983 (42 years ago) |
| Document Number: | G38096 |
| FEI/EIN Number | 592299228 |
| Address: | 23 NE 44TH ST, FORT LAUDERDALE, FL, 33334, US |
| Mail Address: | 23 NE 44TH ST, FORT LAUDERDALE, FL, 33334, US |
| ZIP code: | 33334 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447424858 | 2008-04-16 | 2016-07-29 | 23 NE 44TH ST, OAKLAND PARK, FL, 333341437, US | 23 NE 44TH ST, OAKLAND PARK, FL, 333341437, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 954-776-0363 |
| Fax | 9547764262 |
Authorized person
| Name | ROBERT E. MANN |
| Role | OWNER/OPTICIAN |
| Phone | 9547760363 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | 1603 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 332H00000X - Eyewear Supplier |
| License Number | 1603 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 086606700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LARDIN, THOMAS D., ESQ. | Agent | 2895 n.w. 29 drive, Boca Raton, FL, 33434 |
| Name | Role | Address |
|---|---|---|
| MANN ROBERT E | Vice President | 23 NE 44TH ST, FORT LAUDERDALE, FL, 33334 |
| Name | Role | Address |
|---|---|---|
| Mann Jason S | President | 23 NE 44TH ST, FORT LAUDERDALE, FL, 33334 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
