| Entity Name: | BRAD J. WARONICKI, O.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 Aug 2004 (20 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 14 Mar 2022 (3 years ago) |
| Document Number: | P04000116874 |
| FEI/EIN Number | 800118938 |
| Address: | 2626 SE WILLOUGHBY BLVD., STUART, FL, 34994 |
| Mail Address: | 2626 SE WILLOUGHBY BLVD., STUART, FL, 34994 |
| ZIP code: | 34994 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205955663 | 2007-03-28 | 2020-08-22 | 2626 SE WILLOUGHBY BLVD, STUART, FL, 349944700, US | 2626 SE WILLOUGHBY BLVD, STUART, FL, 349944700, US | |||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 772-286-4878 |
| Fax | 7722864368 |
Authorized person
| Name | DR. BRAD J WARONICKI |
| Role | PRESIDENT |
| Phone | 7722864878 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC 2404 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 156FX1800X - Optician |
| License Number | DO 2488 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | DAVIS VISION |
| Number | 49671 |
| State | FL |
| Issuer | 20272 |
| Number | 20272 |
| State | FL |
| Issuer | METCARE |
| Number | 168 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WARONICKI BRAD J | Agent | 2626 SE WILLOUGHBY BLVD., STUART, FL, 34994 |
| Name | Role | Address |
|---|---|---|
| WARONICKI BRAD JDr. | President | 2626 SE WILLOUGHBY BLVD., STUART, FL, 34994 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G04245700072 | TREASURE COAST EYE & VISION ASSOCIATES | ACTIVE | 2004-09-01 | 2029-12-31 | No data | 2626 SE WILLOUGHBY BLVD, STUART, FL, 34994 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-03-14 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-03-14 | WARONICKI, BRAD J | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-13 |
| ANNUAL REPORT | 2023-01-19 |
| REINSTATEMENT | 2022-03-14 |
| ANNUAL REPORT | 2020-05-18 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-01-23 |
| ANNUAL REPORT | 2017-02-10 |
| ANNUAL REPORT | 2016-03-07 |
| ANNUAL REPORT | 2015-03-05 |
| ANNUAL REPORT | 2014-01-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
