| Entity Name: | EYECARE ASSOCIATES OF VIERA, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 07 Jan 2016 (9 years ago) |
| Document Number: | L16000005565 |
| FEI/EIN Number | 81-3124073 |
| Address: | 8061 SPYGLASS HILL ROAD, UNIT 104A, MELBOURNE, FL, 32940, US |
| Mail Address: | 8061 SPYGLASS HILL ROAD, UNIT 104A, MELBOURNE, FL, 32940, US |
| ZIP code: | 32940 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548703788 | 2016-11-21 | 2016-11-21 | 8061 SPYGLASS HILL RD, SUITE 104A, VIERA, FL, 329408297, US | 8061 SPYGLASS HILL RD, SUITE 104A, VIERA, FL, 329408297, US | |||||||||||||||||||||||||
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| Phone | +1 321-751-6609 |
| Fax | 3217516033 |
Authorized person
| Name | DR. SHAHAN MANGUIKIAN |
| Role | OWNER |
| Phone | 3217516609 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OP 2715 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 620058300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MANGUIKIAN SHAHAN | Agent | 8061 SPYGLASS HILL ROAD, MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| MANGUIKIAN SHAHAN | Officer | 8061 SPYGLASS HILL ROAD, UNIT 104A, MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| MANGUIKIAN SHAHAN | Director | 8061 SPYGLASS HILL ROAD, UNIT 104A, MELBOURNE, FL, 32940 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-26 |
| ANNUAL REPORT | 2023-03-15 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-02-19 |
| ANNUAL REPORT | 2020-03-17 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-03-26 |
| ANNUAL REPORT | 2017-04-04 |
| Florida Limited Liability | 2016-01-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
