| Entity Name: | KIDSEYEDR, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 May 2016 (9 years ago) |
| Document Number: | L16000102561 |
| FEI/EIN Number | 81-2775538 |
| Address: | 915 SE OCEAN BOULEVARD, UNIT # 2, STUART, FL, 34994, US |
| Mail Address: | 915 SE OCEAN BOULEVARD, UNIT # 2, STUART, FL, 34994, US |
| ZIP code: | 34994 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336688720 | 2017-02-17 | 2019-08-27 | 915 SE OCEAN BLVD STE 4, STUART, FL, 349942426, US | 915 SE OCEAN BLVD STE 4, STUART, FL, 349942426, US | |||||||||||||||||||
|
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| Phone | +1 772-249-1038 |
Authorized person
| Name | DR. NEHEMIAH SPENCER |
| Role | OWNER |
| Phone | 7722491038 |
Taxonomy
| Taxonomy Code | 207WX0110X - Pediatric Ophthalmology and Strabismus Specialist Physician Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001380900 |
| State | FL |
| Name | Role |
|---|---|
| INCORP SERVICES, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| SPENCER NEHEMIAH EMD | Authorized Representative | 915 SE OCEAN BOULEVARD, UNIT # 2, STUART, FL, 34994 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000053649 | KIDSEYEDR.COM | ACTIVE | 2016-05-31 | 2027-12-31 | No data | 915 SE OCEAN BOULEVARD, UNIT # 2, STUART, FL, 34994 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-17 | 3458 LAKESHORE DRIVE, TALLAHASSEE, FL 32312 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-16 | 915 SE OCEAN BOULEVARD, UNIT # 2, STUART, FL 34994 | No data |
| CHANGE OF MAILING ADDRESS | 2021-03-16 | 915 SE OCEAN BOULEVARD, UNIT # 2, STUART, FL 34994 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-02-11 |
| ANNUAL REPORT | 2022-03-06 |
| ANNUAL REPORT | 2021-03-16 |
| ANNUAL REPORT | 2020-02-02 |
| ANNUAL REPORT | 2019-02-27 |
| ANNUAL REPORT | 2018-01-03 |
| ANNUAL REPORT | 2017-01-13 |
| Florida Limited Liability | 2016-05-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
