| Entity Name: | KIDSEYERX, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Oct 2019 (5 years ago) |
| Document Number: | L19000272103 |
| FEI/EIN Number | 84-3688278 |
| Address: | 915 SE OCEAN BLVD UNIT # 2, STUART, FL, 34994, US |
| Mail Address: | 915 SE OCEAN BLVD 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 | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962028001 | 2020-06-24 | 2020-06-24 | 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 | +1 772-202-0629 |
Authorized person
| Name | MICHELE BATES-FRIZZELL |
| Role | OWNER |
| Phone | 7722020629 |
Taxonomy
| Taxonomy Code | 332H00000X - Eyewear Supplier |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 104816000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BATES-FRIZZELL MICHELE | Agent | 915 SE OCEAN BLVD UNIT # 2, STUART, FL, FL, 34994 |
| Name | Role | Address |
|---|---|---|
| Bates-Frizzell Michele | Owne | 915 SE OCEAN BLVD UNIT # 2, STUART, FL, 34994 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-16 | 915 SE OCEAN BLVD UNIT # 2, STUART, FL 34994 | No data |
| CHANGE OF MAILING ADDRESS | 2021-03-16 | 915 SE OCEAN BLVD UNIT # 2, STUART, FL 34994 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-16 | 915 SE OCEAN BLVD UNIT # 2, STUART, FL, 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 | 2020-06-10 |
| Florida Limited Liability | 2019-10-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
