| Entity Name: | JUDITH A. ZELLERS OD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 28 Dec 2000 (24 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P01000001530 |
| FEI/EIN Number | 650853275 |
| Address: | 26973 Croise Dr, BONITA SPRINGS, FL, 34135, US |
| Mail Address: | 26973 Croise Dr, BONITA SPRINGS, FL, 34135, US |
| ZIP code: | 34135 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528128667 | 2006-12-11 | 2008-05-12 | 3925 BONITA BEACH RD, BONITA SPRINGS, FL, 341344112, US | 3925 BONITA BEACH RD, BONITA SPRINGS, FL, 341344112, US | |||||||||||||||||||||||||||||||
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| Phone | +1 239-947-6000 |
| Fax | 2399473914 |
Authorized person
| Name | DR. JUDITH ANN ZELLERS |
| Role | OWNER |
| Phone | 2399476000 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC1708 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | STATE LICENSE |
| Number | OPC1708 |
| State | FL |
| Issuer | MEDICAID |
| Number | 078433800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ZELLERS JUDITH A | Agent | 26973 Croise Dr, BONITA SPRINGS, FL, 34135 |
| Name | Role | Address |
|---|---|---|
| ZELLERS JUDITH A | President | 26973 Croise Dr, BONITA SPRINGS, FL, 34135 |
| Name | Role | Address |
|---|---|---|
| ZELLERS JUDITH A | Director | 26973 Croise Dr, BONITA SPRINGS, FL, 34135 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-03-22 | 26973 Croise Dr, BONITA SPRINGS, FL 34135 | No data |
| CHANGE OF MAILING ADDRESS | 2015-03-22 | 26973 Croise Dr, BONITA SPRINGS, FL 34135 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-03-22 | 26973 Croise Dr, BONITA SPRINGS, FL 34135 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13000544693 | TERMINATED | 1000000470020 | LEE | 2013-02-13 | 2023-03-06 | $ 955.29 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT MYERS SERVICE CENTER, 2295 VICTORIA AVE STE 270, FORT MYERS FL339013871 |
| J10000076064 | TERMINATED | 1000000079756 | LEE | 2008-05-14 | 2030-02-15 | $ 991.11 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT MYERS SERVICE CENTER, 2295 VICTORIA AVE STE 270, FORT MYERS FL339013871 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-03-25 |
| ANNUAL REPORT | 2018-03-31 |
| ANNUAL REPORT | 2017-04-16 |
| ANNUAL REPORT | 2016-03-21 |
| ANNUAL REPORT | 2015-03-22 |
| ANNUAL REPORT | 2014-03-24 |
| ANNUAL REPORT | 2013-03-30 |
| ANNUAL REPORT | 2012-03-25 |
| ANNUAL REPORT | 2011-02-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
