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  5. BHAKTA OPTOMETRIC, INC.

BHAKTA OPTOMETRIC, INC.

Company Details

Entity Name: BHAKTA OPTOMETRIC, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 29 Apr 2009 (16 years ago)
Last Event: AMENDMENT AND NAME CHANGE
Event Date Filed: 29 Jun 2021 (4 years ago)
Document Number: P09000038393
FEI/EIN Number 264751859
Address: 8755 Hypoluxo Rd, Ste 2, Lake Worth, FL, 33467, US
Mail Address: 8755 Hypoluxo Rd, Ste 2, Lake Worth, FL, 33467, US
ZIP code: 33467
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1417265455 2010-09-23 2022-03-18 8755 HYPOLUXO RD STE 2, LAKE WORTH, FL, 334675316, US 8755 HYPOLUXO RD STE 2, LAKE WORTH, FL, 334675316, US

Contacts
Phone +1 978-457-0557

Authorized person
Name DR. HETEL BHAKTA
Role OPTOMETRIST
Phone 9784570557

Taxonomy
Taxonomy Code 152W00000X - Optometrist
License Number OPC 4297
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 001645200
State FL
Issuer MEDICARE PTAN
Number BV5192
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BHAKTA OPTOMETRIC INC 401(K) PROFIT SHARING PLAN & TRUST 2023 264751859 2024-06-04 BHAKTA OPTOMETRIC INC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-10-01
Business code 812990
Sponsor’s telephone number 5619657600
Plan sponsor’s address 5875 LAKE WORTH RD, GREENACRES, FL, 33463

Signature of
Role Plan administrator
Date 2024-06-04
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
BHAKTA OPTOMETRIC INC 401(K) PROFIT SHARING PLAN & TRUST 2022 264751859 2023-03-30 BHAKTA OPTOMETRIC INC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-10-01
Business code 812990
Sponsor’s telephone number 5619657600
Plan sponsor’s address 5875 LAKE WORTH RD, GREENACRES, FL, 33463

Signature of
Role Plan administrator
Date 2023-03-30
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
BHAKTA OPTOMETRIC INC 401(K) PROFIT SHARING PLAN & TRUST 2021 264751859 2022-04-21 BHAKTA OPTOMETRIC INC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-10-01
Business code 812990
Sponsor’s telephone number 5619657600
Plan sponsor’s address 5875 LAKE WORTH RD, GREENACRES, FL, 33463

Signature of
Role Plan administrator
Date 2022-04-21
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
BHAKTA OPTOMETRIC INC 401(K) PROFIT SHARING PLAN & TRUST 2020 264751859 2021-04-14 BHAKTA OPTOMETRIC INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-10-01
Business code 812990
Sponsor’s telephone number 5619657600
Plan sponsor’s address 5875 LAKE WORTH RD, GREENACRES, FL, 33463

Signature of
Role Plan administrator
Date 2021-04-14
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
BHAKTA OPTOMETRIC INC 401(K) PROFIT SHARING PLAN & TRUST 2019 264751859 2020-05-06 BHAKTA OPTOMETRIC INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-10-01
Business code 812990
Sponsor’s telephone number 5619657600
Plan sponsor’s address 5875 LAKE WORTH RD, GREENACRES, FL, 33463

Signature of
Role Plan administrator
Date 2020-05-06
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
BHAKTA OPTOMETRIC INC 401 K PROFIT SHARING PLAN TRUST 2018 264751859 2019-04-25 BHAKTA OPTOMETRIC INC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-10-01
Business code 812990
Sponsor’s telephone number 5619657600
Plan sponsor’s address 5875 LAKE WORTH RD, GREENACRES, FL, 33463

Plan administrator’s name and address
Administrator’s EIN 264477125
Plan administrator’s name 401K GENERATION
Plan administrator’s address 195 INTERNATIONAL PKWY, S #311, LAKE MARY, FL, 32746
Administrator’s telephone number 8669985879

Signature of
Role Plan administrator
Date 2019-04-25
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
BHAKTA OPTOMETRIC INC 401 K PROFIT SHARING PLAN TRUST 2017 264751859 2018-05-23 BHAKTA OPTOMETRIC INC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-10-01
Business code 812990
Sponsor’s telephone number 5619657600
Plan sponsor’s address 5875 LAKE WORTH RD, GREENACRES, FL, 33463

Signature of
Role Plan administrator
Date 2018-05-23
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
PLANET VISION EYECARE 401(K) PLAN 2016 264751859 2017-07-13 BHAKTA OPTOMETRIC INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-10-01
Business code 621320
Sponsor’s telephone number 5619657600
Plan sponsor’s address 5875 LAKE WORTH ROAD, GREENACRES, FL, 33463

Signature of
Role Plan administrator
Date 2017-07-13
Name of individual signing BHAKTA OPTOMETRIC INC.
Valid signature Filed with authorized/valid electronic signature
PLANET VISION EYECARE 401(K) PLAN 2015 264751859 2016-07-12 BHAKTA OPTOMETRIC INC. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-10-01
Business code 621320
Sponsor’s telephone number 5619657600
Plan sponsor’s address 5875 LAKE WORTH ROAD, GREENACRES, FL, 33463

Agent

Name Role Address
Bhakta Hetel Agent 8755 Hypoluxo Rd, Lake Worth, FL, 33467

President

Name Role Address
BHAKTA HETEL President 8755 Hypoluxo Rd, Lake Worth, FL, 33467

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000166008 PLANET VISION EYECARE ACTIVE 2021-12-17 2026-12-31 No data 8755 HYPOLUXO RD, STE 2, LAKE WORTH, FL, 33467
G11000007608 PLANET VISION EYECARE CO. EXPIRED 2011-01-18 2016-12-31 No data PLANET VISION, 5875 LAKE WORTH ROAD, GREENACRES, FL, 33463

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2022-03-15 8755 Hypoluxo Rd, Ste 2, Lake Worth, FL 33467 No data
CHANGE OF MAILING ADDRESS 2022-03-15 8755 Hypoluxo Rd, Ste 2, Lake Worth, FL 33467 No data
REGISTERED AGENT NAME CHANGED 2022-03-15 Bhakta, Hetel No data
REGISTERED AGENT ADDRESS CHANGED 2022-03-15 8755 Hypoluxo Rd, Ste 2, Lake Worth, FL 33467 No data
AMENDMENT AND NAME CHANGE 2021-06-29 BHAKTA OPTOMETRIC, INC. No data

Documents

Name Date
ANNUAL REPORT 2024-04-22
ANNUAL REPORT 2023-01-15
ANNUAL REPORT 2022-03-15
Amendment and Name Change 2021-06-29
ANNUAL REPORT 2021-04-08
ANNUAL REPORT 2020-05-21
ANNUAL REPORT 2019-04-05
ANNUAL REPORT 2018-04-11
ANNUAL REPORT 2017-03-17
ANNUAL REPORT 2016-03-20

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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