| Entity Name: | PEDIATRIC OPHTHALMOLOGY ASSOCIATES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 17 Jul 1989 (36 years ago) |
| Document Number: | L02900 |
| FEI/EIN Number | 65-0136922 |
| Address: | 1500 N. DIXIE HWY, #200, W. PALM BEACH, FL 33401 |
| Mail Address: | 1500 N. DIXIE HWY, #200, W. PALM BEACH, FL 33401 |
| ZIP code: | 33401 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780726877 | 2007-02-13 | 2008-02-19 | 1500 N DIXIE HWY, #200, WEST PALM BEACH, FL, 334012712, US | 1500 N DIXIE HWY, #200, WEST PALM BEACH, FL, 334012712, US | |||||||||||||||||||||||||||||||
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| Phone | +1 561-832-3774 |
| Fax | 5618324082 |
Authorized person
| Name | NORMAN C JOHNSON JR. |
| Role | PHYSICIAN PRESIDENT |
| Phone | 5618323774 |
Taxonomy
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| License Number | ME55034 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CIGNA |
| Number | 3739927001 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 09187 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JOHNSON, NORMAN CJR | Agent | 1500 N. DIXIE HWY #200, WEST PALM BEACH, FL 33401 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, NORMAN C JR | Vice President | 1500 N. DIXIE HWY,#200, W. PALM BEACH, FL 33401 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, NORMAN C JR | Treasurer | 1500 N. DIXIE HWY,#200, W. PALM BEACH, FL 33401 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, NORMAN C JR | President | 1500 N. DIXIE HWY,#200, W. PALM BEACH, FL 33401 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2004-01-29 | 1500 N. DIXIE HWY #200, WEST PALM BEACH, FL 33401 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2003-04-25 | 1500 N. DIXIE HWY, #200, W. PALM BEACH, FL 33401 | No data |
| CHANGE OF MAILING ADDRESS | 2003-04-25 | 1500 N. DIXIE HWY, #200, W. PALM BEACH, FL 33401 | No data |
| REGISTERED AGENT NAME CHANGED | 2003-04-25 | JOHNSON, NORMAN CJR | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-04-10 |
| ANNUAL REPORT | 2022-04-14 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-03-12 |
| ANNUAL REPORT | 2019-03-19 |
| ANNUAL REPORT | 2018-03-02 |
| ANNUAL REPORT | 2017-03-21 |
| ANNUAL REPORT | 2016-01-29 |
| ANNUAL REPORT | 2015-03-02 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
