| Entity Name: | MILLENNIUM EYE CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Sep 2005 (19 years ago) |
| Document Number: | P05000126141 |
| FEI/EIN Number | 203582232 |
| Address: | 6601 OLD WINTER GARDEN ROAD, SUITE 104, ORLANDO, FL, 32835, US |
| Mail Address: | 6601 OLD WINTER GARDEN ROAD, SUITE 104, ORLANDO, FL, 32835, US |
| ZIP code: | 32835 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790721652 | 2006-06-21 | 2011-06-22 | 6601 OLD WINTER GARDEN RD, SUIT 104, ORLANDO, FL, 328351221, US | 6601 OLD WINTER GARDEN RD, SUIT 104, ORLANDO, FL, 328351221, US | |||||||||||||||||||||||||
|
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| Phone | +1 407-292-9812 |
| Fax | 4072929813 |
Authorized person
| Name | DR. MARIE LAURETTA SEIDE-JUSTIN |
| Role | PRESIDENT |
| Phone | 4072929812 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC003955 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 621147000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JUSTIN LAURETTA O | Agent | 6601 OLD WINTER GARDEN ROAD, ORLANDO, FL, 32835 |
| Name | Role | Address |
|---|---|---|
| JUSTIN LAURETTA O | President | 6601 OLD WINTER GARDEN ROAD STE 104, ORLANDO, FL, 32835 |
| Name | Role | Address |
|---|---|---|
| JUSTIN JAMES | Vice President | 6601 OLD WINTER GARDEN ROAD STE 104, ORLANDO, FL, 32835 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2011-02-15 | JUSTIN, LAURETTA O.D | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-01-11 | 6601 OLD WINTER GARDEN ROAD, 104, ORLANDO, FL 32835 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-03-28 | 6601 OLD WINTER GARDEN ROAD, SUITE 104, ORLANDO, FL 32835 | No data |
| CHANGE OF MAILING ADDRESS | 2009-03-28 | 6601 OLD WINTER GARDEN ROAD, SUITE 104, ORLANDO, FL 32835 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| ANNUAL REPORT | 2023-02-09 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-03-13 |
| ANNUAL REPORT | 2020-01-30 |
| ANNUAL REPORT | 2019-03-23 |
| ANNUAL REPORT | 2018-03-27 |
| ANNUAL REPORT | 2017-01-06 |
| ANNUAL REPORT | 2016-03-16 |
| ANNUAL REPORT | 2015-01-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
