| Entity Name: | BUENA VISTA EYELAND, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Sep 2003 (21 years ago) |
| Document Number: | P03000107494 |
| FEI/EIN Number | 900110995 |
| Address: | 1619 US HIGHWAY 1, SEBASTIAN, FL, 32958, US |
| Mail Address: | 1619 US HIGHWAY 1, SEBASTIAN, FL, 32958, US |
| ZIP code: | 32958 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205829033 | 2005-08-26 | 2008-02-13 | 1619 US HIGHWAY 1, SEBASTIAN, FL, 329583834, US | 1619 US HIGHWAY 1, SEBASTIAN, FL, 329583834, US | |||||||||||||||||||||||||
|
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| Phone | +1 772-388-9330 |
| Fax | 7723883036 |
Authorized person
| Name | DR. CARLO DANIEL FODOR |
| Role | PRESIDENT |
| Phone | 7723889330 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC003794 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 620854100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SCHILLINGER CHARLES A | Agent | 1329 BEDFORD DRIVE, MELBOURNE, FL, 32958 |
| Name | Role | Address |
|---|---|---|
| FODOR CARLO D | President | 1619 U.S HWY 1, SEBASTIAN, FL, 32958 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-04-03 |
| ANNUAL REPORT | 2022-04-13 |
| ANNUAL REPORT | 2021-04-08 |
| ANNUAL REPORT | 2020-04-17 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-26 |
| ANNUAL REPORT | 2017-04-25 |
| ANNUAL REPORT | 2016-04-07 |
| ANNUAL REPORT | 2015-03-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
