| Entity Name: | MAXIM-EYES OPTICAL, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 10 Oct 2002 (22 years ago) |
| Document Number: | P02000109498 |
| FEI/EIN Number | 743064622 |
| Address: | 2615 East State Road 60, VALRICO, FL, 33594, US |
| Mail Address: | 2615 East State Road 60, VALRICO, FL, 33594, US |
| ZIP code: | 33594 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386042026 | 2014-12-11 | 2014-12-11 | 2547 E STATE ROAD 60, VALRICO, FL, 335943830, US | 2547 E STATE ROAD 60, VALRICO, FL, 335943830, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 813-653-9661 |
| Fax | 8136574334 |
Authorized person
| Name | DULCIE KIFFNER |
| Role | PRESIDENT |
| Phone | 8136539661 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC2050 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 156FX1800X - Optician |
| License Number | DO4868 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 630341200 |
| State | FL |
| Issuer | MEDICAID |
| Number | 078763900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KIFFNER DULCIE | Agent | 1116 CARRIAGE PARK DRIVE, VALRICO, FL, 33594 |
| Name | Role | Address |
|---|---|---|
| KIFFNER DULCIE | Director | 1116 CARRIAGE PARK DRIVE, VALRICO, FL, 33594 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-17 | 2615 East State Road 60, VALRICO, FL 33594 | No data |
| CHANGE OF MAILING ADDRESS | 2019-04-17 | 2615 East State Road 60, VALRICO, FL 33594 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-03-22 | 1116 CARRIAGE PARK DRIVE, VALRICO, FL 33594 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-03-10 |
| ANNUAL REPORT | 2021-03-19 |
| ANNUAL REPORT | 2020-02-27 |
| ANNUAL REPORT | 2019-04-17 |
| ANNUAL REPORT | 2018-03-08 |
| ANNUAL REPORT | 2017-04-12 |
| ANNUAL REPORT | 2016-02-18 |
| ANNUAL REPORT | 2015-04-16 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
