| Entity Name: | EYEBIS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Jan 2018 (7 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 10 Aug 2023 (a year ago) |
| Document Number: | L18000003324 |
| FEI/EIN Number | 82-3931512 |
| Address: | 2161 E COUNTY ROAD, 540A #254, LAKELAND, FL, 33813, US |
| Mail Address: | 2161 E COUNTY ROAD, 540A #254, LAKELAND, FL, 33813, US |
| ZIP code: | 33813 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649866815 | 2020-12-11 | 2024-05-28 | 2161 E COUNTY ROAD 540A # 254, LAKELAND, FL, 338133794, US | 7450 CYPRESS GARDENS BLVD, WINTER HAVEN, FL, 338846200, US | |||||||||||||||||||||||
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| Phone | +1 484-477-2579 |
| Phone | +1 863-310-0329 |
| Fax | 8133180348 |
Authorized person
| Name | KEION MARK |
| Role | MANAGING PROVIDER |
| Phone | 4844772579 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 019517900 |
| State | FL |
| Name | Role |
|---|---|
| UNITED STATES CORPORATION AGENTS, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| MARK KEION | Authorized Member | 2161 E COUNTY ROAD, LAKELAND, FL, 33813 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2023-08-10 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-08-10 | 2161 E COUNTY ROAD, 540A #254, LAKELAND, FL 33813 | No data |
| CHANGE OF MAILING ADDRESS | 2023-08-10 | 2161 E COUNTY ROAD, 540A #254, LAKELAND, FL 33813 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-18 | 476 RIVERSIDE AVE., JACKSONVILLE, FL 32202 | No data |
| LC AMENDMENT | 2019-09-16 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-11 |
| LC Amendment | 2023-08-10 |
| ANNUAL REPORT | 2023-03-18 |
| ANNUAL REPORT | 2022-03-10 |
| ANNUAL REPORT | 2021-02-08 |
| ANNUAL REPORT | 2020-06-26 |
| LC Amendment | 2019-09-16 |
| ANNUAL REPORT | 2019-04-24 |
| Florida Limited Liability | 2018-01-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
