| Entity Name: | 3D EYEWEAR, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 15 Feb 2008 (17 years ago) |
| Date of dissolution: | 25 Sep 2009 (15 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (15 years ago) |
| Document Number: | L08000018093 |
| Address: | 4505 E HILLSBOROUGH AVE, SUITE B, TAMPA, FL, 33610 |
| Mail Address: | 4505 E HILLSBOROUGH AVE, SUITE B, TAMPA, FL, 33610 |
| ZIP code: | 33610 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1427380120 | 2010-02-04 | 2010-02-04 | 4505 E HILLSBOROUGH AVE, SUITE B, TAMPA, FL, 336105200, US | 4505 E HILLSBOROUGH AVE, SUITE B, TAMPA, FL, 336105200, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 813-319-3904 |
| Fax | 8133193997 |
Authorized person
| Name | MRS. TAMIKO D DAVIS |
| Role | LICENSED OPTICIAN |
| Phone | 8133193904 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | No |
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OB3204 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 152WP0200X - Pediatric Optometrist |
| Is Primary | No |
| Taxonomy Code | 152WS0006X - Sports Vision Optometrist |
| Is Primary | No |
| Taxonomy Code | 156FC0800X - Contact Lens Technician/Technologist |
| Is Primary | No |
| Taxonomy Code | 156FC0801X - Contact Lens Fitter |
| Is Primary | No |
| Taxonomy Code | 156FX1101X - Ophthalmic Assistant |
| License Number | DO4826 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 156FX1202X - Optometric Technician |
| Is Primary | No |
| Taxonomy Code | 156FX1800X - Optician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 630366800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DAVIS MITCHELL I | Agent | 4505 E HILLSBOROUGH AVE., TAMPA, FL, 33610 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2008-02-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
