| Entity Name: | DOCTOR PHAN EYE CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
DOCTOR PHAN EYE CARE, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 22 Dec 2014 (10 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 22 Oct 2015 (9 years ago) |
| Document Number: | L14000193955 |
| FEI/EIN Number |
47-2647119
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 670 TENNIS CLUB DR, FORT LAUDERDALE, FL, 33311, US |
| Mail Address: | 670 TENNIS CLUB DR, FORT LAUDERDALE, FL, 33311, US |
| ZIP code: | 33311 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184012668 | 2015-01-06 | 2015-03-05 | 19501 NW 27TH AVE, MIAMI GARDENS, FL, 330562521, US | 19501 NW 27TH AVE, MIAMI GARDENS, FL, 330562521, US | |||||||||||||||||||||||
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| Phone | +1 305-974-2588 |
Authorized person
| Name | DR. KHAI G PHAN |
| Role | OWNER |
| Phone | 3059742588 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC3501 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 014191100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PHAN KHAI G | DOCT | 670 TENNIS CLUB DR, FORT LAUDERDALE, FL, 33311 |
| PHAN KHAI G | Agent | 670 TENNIS CLUB DRIVE #311, FORT LAUDERDALE, FL, 33311 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-18 | 670 TENNIS CLUB DR, 311, FORT LAUDERDALE, FL 33311 | - |
| CHANGE OF MAILING ADDRESS | 2022-01-18 | 670 TENNIS CLUB DR, 311, FORT LAUDERDALE, FL 33311 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-18 | 670 TENNIS CLUB DRIVE #311, 311, FORT LAUDERDALE, FL 33311 | - |
| REGISTERED AGENT NAME CHANGED | 2019-01-29 | PHAN, KHAI G | - |
| REINSTATEMENT | 2015-10-22 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-27 |
| ANNUAL REPORT | 2023-01-06 |
| ANNUAL REPORT | 2022-01-18 |
| ANNUAL REPORT | 2021-04-06 |
| ANNUAL REPORT | 2020-01-31 |
| ANNUAL REPORT | 2019-01-29 |
| ANNUAL REPORT | 2018-06-28 |
| ANNUAL REPORT | 2017-02-09 |
| ANNUAL REPORT | 2016-04-15 |
| REINSTATEMENT | 2015-10-22 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1321377300 | 2020-04-28 | 0455 | PPP | 2300 W ATLANTIC BLVD, POMPANO BEACH, FL, 33069-2655 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5856708707 | 2021-04-03 | 0455 | PPS | 660 Tennis Club Dr Apt 308, Wilton Manors, FL, 33311-4021 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Mar 2025
Sources: Florida Department of State
