| Entity Name: | BEDOYA EYE CARE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 Feb 2003 (22 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 29 Apr 2014 (11 years ago) |
| Document Number: | P03000021964 |
| FEI/EIN Number | 562321799 |
| Address: | 876 SW SR 247, LAKE CITY, FL, 32025 |
| Mail Address: | 876 SW SR 247, LAKE CITY, FL, 32025 |
| ZIP code: | 32025 |
| County: | Columbia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124033832 | 2006-07-30 | 2010-07-15 | 4206 NW WISTERIA DR, LAKE CITY, FL, 320554804, US | 876 SW STATE ROAD 247, LAKE CITY, FL, 320258308, US | |||||||||||||||||||||
|
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| Phone | +1 386-755-7595 |
| Fax | 3867557561 |
Authorized person
| Name | EDUARDO BEDOYA |
| Role | OWNER |
| Phone | 3867557595 |
Taxonomy
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002016400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BEDOYA EDUARDO MM.D. | Agent | 876 SW STATE ROAD 247, LAKE CITY, FL, 32025 |
| Name | Role | Address |
|---|---|---|
| BEDOYA EDUARDO M | President | 876 SW STATE ROAD 247, LAKE CITY, FL, 32025 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2014-04-29 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-04-29 | 876 SW STATE ROAD 247, LAKE CITY, FL 32025 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-11-29 | 876 SW SR 247, LAKE CITY, FL 32025 | No data |
| CHANGE OF MAILING ADDRESS | 2007-11-29 | 876 SW SR 247, LAKE CITY, FL 32025 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-03-02 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-04-16 |
| ANNUAL REPORT | 2020-04-27 |
| ANNUAL REPORT | 2019-04-05 |
| ANNUAL REPORT | 2018-04-09 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-07-12 |
| ANNUAL REPORT | 2015-05-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
