| Entity Name: | PEMBROKE LAKES OPTICAL, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 06 Oct 2007 (17 years ago) |
| Date of dissolution: | 24 Jul 2023 (2 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 24 Jul 2023 (2 years ago) |
| Document Number: | P07000121120 |
| FEI/EIN Number | 261358078 |
| Address: | 1673 NORTH HIATAS ROAD, PEMBROKE PINES, FL, 33026 |
| Mail Address: | 1673 NORTH HIATAS ROAD, PEMBROKE PINES, FL, 33026 |
| ZIP code: | 33026 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780845222 | 2008-06-18 | 2008-06-18 | 1673 N HIATUS RD, PEMBROKE PINES, FL, 330262129, US | 1673 N HIATUS RD, PEMBROKE PINES, FL, 330262129, US | |||||||||||||||||||||||||
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| Phone | +1 954-442-6703 |
| Fax | 9544426769 |
Authorized person
| Name | DR. PETER L GOMEZ |
| Role | PRESIDENT |
| Phone | 9544426703 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC3345 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 620641701 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GOMEZ PETER L | Agent | 20250 NE 3RD COURT, #5, NORTH MIAMI BEACH, FL, 33179 |
| Name | Role | Address |
|---|---|---|
| GOMEZ PETER L | Director | 20250 NE 3RD COURT, #5, NORTH MIAMI BEACH, FL, 33179 |
| Name | Role | Address |
|---|---|---|
| GOMEZ PETER L | President | 20250 NE 3RD COURT, #5, NORTH MIAMI BEACH, FL, 33179 |
| Name | Role | Address |
|---|---|---|
| GOMEZ PETER L | Treasurer | 20250 NE 3RD COURT, #5, NORTH MIAMI BEACH, FL, 33179 |
| Name | Role | Address |
|---|---|---|
| GOMEZ PETER L | Vice President | 20250 NE 3RD COURT, #5, NORTH MIAMI BEACH, FL, 33179 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2023-07-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2009-04-28 | GOMEZ, PETER L | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J17000550261 | LAPSED | CONO-17-5129 | COUNTY COURT BROWARD COUNTY | 2017-09-18 | 2022-10-09 | $9,287.86 | ESSILOR LABORATORIES OF AMERICA, INC., 13515 N STEMMONS FREEWAY, SUITE 1133, DALLAS, TX 75234 |
| J09001065498 | TERMINATED | 1000000113693 | 46043 903 | 2009-03-11 | 2029-04-01 | $ 1,017.09 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, HOLLYWOOD SERVICE CENTER, 6565 TAFT ST STE 300, HOLLYWOOD FL330244044 |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2023-07-24 |
| ANNUAL REPORT | 2022-03-10 |
| ANNUAL REPORT | 2021-04-02 |
| ANNUAL REPORT | 2020-05-23 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-04-21 |
| ANNUAL REPORT | 2016-03-25 |
| ANNUAL REPORT | 2015-01-21 |
| ANNUAL REPORT | 2014-02-05 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
