| Entity Name: | OPTIMAL EYECARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Dec 2021 (3 years ago) |
| Document Number: | L21000515832 |
| FEI/EIN Number | 874064741 |
| Address: | 2143 Tyrone Blvd N, St. Petersburg, FL, 33710, US |
| Mail Address: | 1211 46TH AVE N, ST. PETERSBURG, FL, 33703, US |
| ZIP code: | 33710 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396498184 | 2022-02-01 | 2022-02-01 | 1211 46TH AVE N, ST PETERSBURG, FL, 337034411, US | 2001 E FOWLER AVE, TAMPA, FL, 336125500, US | |||||||||||||||||||||||||||
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| Phone | +1 614-284-3791 |
| Phone | +1 813-972-5728 |
Authorized person
| Name | DR. BARRY AVI CASE |
| Role | OPTOMETRIST/OWNER |
| Phone | 9414212684 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 014768600 |
| State | FL |
| Issuer | MEDICAID |
| Number | 104525200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CASE BARRY A | Agent | 11212 PARK BLVD, SEMINOLE, FL, 33772 |
| Name | Role | Address |
|---|---|---|
| CASE BARRY A | Manager | 1211 46TH AVE N, ST. PETERSBURG, FL, 33703 |
| DAO THIEN-TRANG K | Manager | 1211 46TH AVE N, ST. PETERSBURG, FL, 33703 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000128624 | NATIONAL EYECARE RECRUITERS | ACTIVE | 2024-10-17 | 2029-12-31 | No data | 1211 46TH AVE N, SAINT PETERSBURG, FL, 33703 |
| G23000008843 | FLORIDA OPTOMETRY RECRUITERS | ACTIVE | 2023-01-19 | 2028-12-31 | No data | 2001 E FOWLER AVE, TAMPA, FL, 33612 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-06 | 2143 Tyrone Blvd N, St. Petersburg, FL 33710 | No data |
| CHANGE OF MAILING ADDRESS | 2022-06-21 | 2143 Tyrone Blvd N, St. Petersburg, FL 33710 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-17 |
| Florida Limited Liability | 2021-12-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
