| Entity Name: | HUMERA SIDDIQUI, O.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 25 Jan 2005 (20 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 26 Dec 2022 (2 years ago) |
| Document Number: | P05000013064 |
| FEI/EIN Number | 050616043 |
| Address: | 904 CYPRESS PARKWAY, WALMART VISION CENTER, KISSIMMEE, FL, 34759, US |
| Mail Address: | 7443 Lake Albert Drive, Windermere, FL, 34786, US |
| ZIP code: | 34759 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174762991 | 2009-02-18 | 2009-02-18 | 904 CYPRESS PKWY, KISSIMMEE, FL, 347593456, US | 904 CYPRESS PKWY, KISSIMMEE, FL, 347593456, US | |||||||||||||||||||
|
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| Phone | +1 407-870-2405 |
| Fax | 4078702409 |
Authorized person
| Name | DR. HUMERA SIDDIQUI |
| Role | OPTOMETRIST |
| Phone | 4078702405 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC 3767 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SIDDIQUI HUMERA | Agent | 7443 Lake Albert Drive, Windermere, FL, 34786 |
| Name | Role | Address |
|---|---|---|
| SIDDIQUI HUMERA | President | 7443 Lake Albert Drive, Windermere, FL, 34786 |
| Name | Role | Address |
|---|---|---|
| SIDDIQUI NAUMAN A | Vice President | 7443 Lake Albert Drive, Windermere, FL, 34786 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-12-26 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-12-26 | SIDDIQUI, HUMERA | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2015-04-24 | 904 CYPRESS PARKWAY, WALMART VISION CENTER, KISSIMMEE, FL 34759 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-04-24 | 7443 Lake Albert Drive, Windermere, FL 34786 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-03-31 |
| REINSTATEMENT | 2022-12-26 |
| ANNUAL REPORT | 2021-05-20 |
| ANNUAL REPORT | 2020-04-28 |
| ANNUAL REPORT | 2019-04-19 |
| ANNUAL REPORT | 2018-04-08 |
| ANNUAL REPORT | 2017-02-10 |
| ANNUAL REPORT | 2016-04-06 |
| ANNUAL REPORT | 2015-04-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
