| Entity Name: | ISLAND OPTICS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Jun 2018 (7 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 16 Nov 2020 (4 years ago) |
| Document Number: | L18000154053 |
| FEI/EIN Number | 35-2633983 |
| Address: | 5290 Seminole Blvd, St Petersburg, FL, 33708, US |
| Mail Address: | 5290 Seminole Blvd, St Petersburg, FL, 33708, US |
| ZIP code: | 33708 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215414487 | 2018-07-20 | 2018-07-20 | 15037 MADEIRA WAY, MADEIRA BEACH, FL, 337081911, US | 15037 MADEIRA WAY, MADEIRA BEACH, FL, 337081911, US | |||||||||||||||||||||||
|
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| Phone | +1 727-800-4411 |
Authorized person
| Name | REBEKAH VENEZIANO |
| Role | OWNER |
| Phone | 6172231044 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC4673 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004718000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SMITH REBEKAH | Agent | 7245 103rd Lane, Seminole, FL, 33772 |
| Name | Role | Address |
|---|---|---|
| SMITH REBEKAH | Officer | 7245 103RD LN, SEMINOLE, FL, 33708 |
| Name | Role | Address |
|---|---|---|
| SMITH REBEKAH | Director | 7245 103RD LN, SEMINOLE, FL, 33708 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000053508 | REBEKAH SMITH OPTOMETRIST | ACTIVE | 2021-04-19 | 2026-12-31 | No data | 5290 SEMINOLE BLVD, SUITE F, ST. PETERSBURG, FL, 33708 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-14 | 5290 Seminole Blvd, Suite F, St Petersburg, FL 33708 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-14 | 5290 Seminole Blvd, Suite F, St Petersburg, FL 33708 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-14 | 7245 103rd Lane, Seminole, FL 33772 | No data |
| LC AMENDMENT | 2020-11-16 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-11-16 | SMITH, REBEKAH | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-24 |
| ANNUAL REPORT | 2023-02-17 |
| ANNUAL REPORT | 2022-02-22 |
| ANNUAL REPORT | 2021-04-14 |
| LC Amendment | 2020-11-16 |
| ANNUAL REPORT | 2020-06-17 |
| ANNUAL REPORT | 2019-02-27 |
| Florida Limited Liability | 2018-06-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
