| Entity Name: | AMANDA SANFORD, OD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 13 Dec 2017 (7 years ago) |
| Document Number: | L17000254922 |
| FEI/EIN Number | 82-3202045 |
| Address: | 12331 sw 3rd st, Suite 300, Plantation, FL 33325 |
| Mail Address: | 11089 Nashville Dr., Cooper City, FL 33026 |
| ZIP code: | 33325 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023725231 | 2022-10-28 | 2023-01-18 | 12331 SW 3RD ST STE 300, PLANTATION, FL, 333252815, US | 12331 SW 3RD ST STE 300, PLANTATION, FL, 333252815, US | |||||||||||||||||||
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| Phone | +1 605-690-8580 |
Authorized person
| Name | AMANDA M SANFORD |
| Role | OWNER |
| Phone | 6056908580 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 114222800 |
| State | FL |
| Name | Role |
|---|---|
| ALTON LAW, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| SANFORD, AMANDA | Officer | 11089 Nashville Dr., Cooper City, FL 33026 |
| Name | Role | Address |
|---|---|---|
| SANFORD, AMANDA | Director | 11089 Nashville Dr., Cooper City, FL 33026 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000008101 | EYES ON 3RD | ACTIVE | 2023-01-18 | 2028-12-31 | No data | 12331 SW 3RD ST, PLANTATION, FL, 33325 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-04-26 | Alton Law, LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-26 | 1931 NW 150th Avenue, Suite 274, Pembroke Pines, FL 33028 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-14 | 12331 sw 3rd st, Suite 300, Plantation, FL 33325 | No data |
| CHANGE OF MAILING ADDRESS | 2020-04-28 | 12331 sw 3rd st, Suite 300, Plantation, FL 33325 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-26 |
| ANNUAL REPORT | 2023-04-14 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-15 |
| ANNUAL REPORT | 2020-04-28 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-09-17 |
| Florida Limited Liability | 2017-12-13 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7010898103 | 2020-07-22 | 0455 | PPP | 8211 W BROWARD BLVD PH 2, PLANTATION, FL, 33324 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 17 Feb 2025
Sources: Florida Department of State
