| Entity Name: | FLORIDA EYE & PLASTIC SURGERY ASSOCIATES INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Feb 2000 (25 years ago) |
| Document Number: | P00000020635 |
| FEI/EIN Number | 650988198 |
| Address: | 6894 LAKE WORTH ROAD, 105, LAKE WORTH, FL, 33467 |
| Mail Address: | 11195 S. JOG RD, SUITE 2, BOYNTON BEACH, FL, 33437 |
| ZIP code: | 33467 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467497529 | 2006-06-20 | 2008-04-29 | 10075 JOG RD, SUITE 301, BOYNTON BEACH, FL, 334373535, US | 10075 JOG RD, SUITE 301, BOYNTON BEACH, FL, 334373535, US | |||||||||||||||||||
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| Phone | +1 561-752-0075 |
Authorized person
| Name | SIRTAZ SINGH SIBIA |
| Role | OWNER/PRESIDENT |
| Phone | 5617520075 |
Taxonomy
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 49882 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FLORIDA EYE & PLASTIC SURGERY 401(K) PROFIT SHARING PLAN AND TRUST | 2018 | 650988198 | 2019-07-30 | FLORIDA EYE & PLASTIC SURGERY ASSOCIATES, INC. | 25 | |||||||||||||
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| FLORIDA EYE & PLASTIC SURGERY 401(K) PROFIT SHARING PLAN AND TRUST | 2018 | 650988198 | 2019-11-19 | FLORIDA EYE & PLASTIC SURGERY ASSOCIATES, INC. | 36 | |||||||||||||
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| FLORIDA EYE & PLASTIC SURGERY 401(K) PROFIT SHARING PLAN AND TRUST | 2017 | 650988198 | 2018-06-07 | FLORIDA EYE & PLASTIC SURGERY ASSOCIATES, INC. | 24 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| SIBIA SIRTAZ | Agent | 17825 FIELDBROOK CIRCLE W., BOCA RATON, FL, 33496 |
| Name | Role | Address |
|---|---|---|
| SIBIA SIRTAZ | Director | 17825 FIELDBROOK CIRCLE W., BOCA RATON, FL, 33496 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G06342900040 | SIBIA EYE INSTITUTE | ACTIVE | 2006-12-07 | 2026-12-31 | No data | 6894 LAKE WORTH ROAD, SUITE 105, LAKE WORTH, FL, 33467 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2011-04-10 | 6894 LAKE WORTH ROAD, 105, LAKE WORTH, FL 33467 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-04-25 | 6894 LAKE WORTH ROAD, 105, LAKE WORTH, FL 33467 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-23 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-02-17 |
| ANNUAL REPORT | 2020-03-17 |
| ANNUAL REPORT | 2019-03-10 |
| ANNUAL REPORT | 2018-03-26 |
| ANNUAL REPORT | 2017-03-20 |
| ANNUAL REPORT | 2016-03-07 |
| ANNUAL REPORT | 2015-04-10 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
