| Entity Name: | ISLAND CITY EYECARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 17 Dec 2008 (16 years ago) |
| Date of dissolution: | 27 Jan 2023 (2 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 27 Jan 2023 (2 years ago) |
| Document Number: | L08000114853 |
| FEI/EIN Number | 264031781 |
| Address: | 2301 WILTON DR, C1, WILTON MANORS, FL, 33305 |
| Mail Address: | 2301 WILTON DR, C1, WILTON MANORS, FL, 33305 |
| ZIP code: | 33305 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649446097 | 2008-05-06 | 2014-05-07 | 2301 WILTON DR, UNIT C1, WILTON MANORS, FL, 333051202, US | 2301 WILTON DR, UNIT C1, WILTON MANORS, FL, 333051202, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 954-764-6906 |
| Fax | 9544637933 |
Authorized person
| Name | SANDRA BRAUSS |
| Role | SECRETARY |
| Phone | 9547646906 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC001072 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 078966600 |
| State | FL |
| Issuer | BCBS |
| Number | 000J1 |
| State | FL |
| Issuer | MEDICAID |
| Number | 084758500 |
| State | FL |
| Issuer | BCBS |
| Number | 20512 |
| State | FL |
| Issuer | AVMED |
| Number | 321773 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 19523 |
| State | FL |
| Issuer | AETNA |
| Number | 3446264 |
| State | FL |
| Issuer | DMERC CIGNA |
| Number | 6374970001 |
| State | FL |
| Issuer | AVMED |
| Number | 220833 |
| State | FL |
| Issuer | MEDICAID |
| Number | 621354500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FEINER ROD A | Agent | 1404 SOUTH ANDREWS AVENUE, FORT LAUDERDALE, FL, 33316 |
| Name | Role | Address |
|---|---|---|
| SHAFFER ALAN | Managing Member | 2301 WILTON DR, C1, WILTON MANORS, FL, 33305 |
| BRAUSS JAMES | Managing Member | 2301 WILTON DR, C1, WILTON MANORS, FL, 33305 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2023-01-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-11-02 | 2301 WILTON DR, C1, WILTON MANORS, FL 33305 | No data |
| CHANGE OF MAILING ADDRESS | 2009-11-02 | 2301 WILTON DR, C1, WILTON MANORS, FL 33305 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2023-01-27 |
| ANNUAL REPORT | 2022-01-19 |
| ANNUAL REPORT | 2021-01-30 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-01-11 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-01-23 |
| ANNUAL REPORT | 2015-01-13 |
| ANNUAL REPORT | 2014-01-09 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
