| Entity Name: | FAMILY EYE CARE OF WESTSHORE, P.L. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 06 Aug 2008 (17 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | L08000075286 |
| FEI/EIN Number | 263214970 |
| Address: | 1108-C SOUTH DALE MABRY HWY, TAMPA, FL, 33629, US |
| Mail Address: | 1108-C SOUTH DALE MABRY HWY, TAMPA, FL, 33629, US |
| ZIP code: | 33629 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194969907 | 2009-04-23 | 2009-09-18 | 4040 W KENNEDY BLVD, TAMPA, FL, 336092750, US | 4040 W KENNEDY BLVD, TAMPA, FL, 336092750, US | |||||||||||||||||||||||||
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| Phone | +1 813-286-0433 |
| Fax | 8132860498 |
Authorized person
| Name | KENNETH H GREEN |
| Role | MANAGER |
| Phone | 8132860433 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC1473 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 078017100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CLARKE PHILIP | Agent | 1505 N. FLORIDA AVENUE, TAMPA, FL, 33601 |
| Name | Role | Address |
|---|---|---|
| GREEN KENNETH H | Manager | 1108 South Dale Mabry Hwy, TAMPA, FL, 33629 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-09-26 | 1108-C SOUTH DALE MABRY HWY, TAMPA, FL 33629 | No data |
| CHANGE OF MAILING ADDRESS | 2013-09-26 | 1108-C SOUTH DALE MABRY HWY, TAMPA, FL 33629 | No data |
| LC NAME CHANGE | 2008-09-04 | FAMILY EYE CARE OF WESTSHORE, P.L. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-04-29 |
| ANNUAL REPORT | 2014-01-09 |
| ANNUAL REPORT | 2013-01-27 |
| ANNUAL REPORT | 2012-01-17 |
| ANNUAL REPORT | 2011-02-08 |
| ANNUAL REPORT | 2010-01-05 |
| ANNUAL REPORT | 2009-01-15 |
| LC Name Change | 2008-09-04 |
| Florida Limited Liability | 2008-08-06 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
