| Entity Name: | EYE SURGERY CENTER OF NORTH FLORIDA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 03 Aug 2006 (19 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 16 Dec 2022 (2 years ago) |
| Document Number: | L06000076842 |
| FEI/EIN Number | 205326854 |
| Address: | 7205 Bentley Road, JACKSONVILLE, FL, 32256, US |
| Mail Address: | 7205 Bentley Road, JACKSONVILLE, FL, 32256, US |
| ZIP code: | 32256 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275740839 | 2007-05-16 | 2010-02-16 | 7205 BONNEVAL RD, JACKSONVILLE, FL, 322567565, US | 7205 BONNEVAL ROAD, JACKSONVILLE, FL, 32256, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-296-0098 |
| Fax | 9042934331 |
| Phone | +1 904-296-4331 |
| Fax | 9048613599 |
Authorized person
| Name | MRS. PATTI BARKEY |
| Role | ADMINISTRATOR |
| Phone | 9048613888 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 66I |
| State | FL |
| Issuer | MEDICAID |
| Number | 001031700 |
| State | FL |
| Issuer | MEDICARE RAILROAD |
| Number | P00445115 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BARKEY PATTI | Agent | 7205 Bentley Road, JACKSONVILLE, FL, 32256 |
| Name | Role | Address |
|---|---|---|
| Barkey Patti | Admi | 7205 Bentley Road, JACKSONVILLE, FL, 32256 |
| Name | Role | Address |
|---|---|---|
| Bowden Frank W | Medi | 7205 Bentley Road, Jacksonville, FL, 32256 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-12-16 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-02-08 | 7205 Bentley Road, JACKSONVILLE, FL 32256 | No data |
| CHANGE OF MAILING ADDRESS | 2021-02-08 | 7205 Bentley Road, JACKSONVILLE, FL 32256 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-02-08 | 7205 Bentley Road, JACKSONVILLE, FL 32256 | No data |
| REINSTATEMENT | 2020-11-17 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REINSTATEMENT | 2018-10-16 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| REINSTATEMENT | 2016-10-19 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-20 |
| ANNUAL REPORT | 2023-02-02 |
| REINSTATEMENT | 2022-12-16 |
| ANNUAL REPORT | 2021-02-08 |
| REINSTATEMENT | 2020-11-17 |
| ANNUAL REPORT | 2019-05-29 |
| REINSTATEMENT | 2018-10-16 |
| ANNUAL REPORT | 2017-05-02 |
| REINSTATEMENT | 2016-10-19 |
| ANNUAL REPORT | 2015-08-17 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5688977210 | 2020-04-27 | 0491 | PPP | 7205 Bonneval Road, JACKSONVILLE, FL, 32256-7565 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Feb 2025
Sources: Florida Department of State
