| Entity Name: | EYE-STYLE OPTICAL, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 11 Sep 1989 (35 years ago) |
| Document Number: | L14748 |
| FEI/EIN Number | 592969014 |
| Address: | EYE-STYLE OPTICAL, INC, 1240 PALM COAST PARKWAY S.W., PALM COAST, FL, 32137, US |
| Mail Address: | EYE-STYLE OPTICAL, INC, 1240 PALM COAST PARKWAY S.W., PALM COAST, FL, 32137, US |
| ZIP code: | 32137 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699826552 | 2007-01-16 | 2020-08-22 | 7 OLD KINGS RD N STE 32, PALM COAST, FL, 321378247, US | 7 OLD KINGS RD N STE 32, PALM COAST, FL, 321378247, US | |||||||||||||||||||||||||
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| Phone | +1 386-446-4210 |
| Fax | 3864457309 |
Authorized person
| Name | JADE JACKSON |
| Role | OWNER |
| Phone | 3864464210 |
Taxonomy
| Taxonomy Code | 156FX1800X - Optician |
| License Number | DO3668 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | EYEMED PROVIDER ID# |
| Number | OP0463 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JACKSON JADE L | Agent | 1240 PALM COAST PARKWAY S.W., PALM COAST, FL, 32137 |
| Name | Role | Address |
|---|---|---|
| JACKSON JEREMY C | President | 1240 PALM COAST PARKWAY SW, PALM COAST, FL, 32137 |
| Name | Role | Address |
|---|---|---|
| JACKSON JADE L | Vice President | 1240 PALM COAST PARKWAY SW, PALM COAST, FL, 32137 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2019-07-26 | No data | No data |
| AMENDMENT | 1995-07-26 | No data | No data |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
