| Entity Name: | CHAUNTEL DA SILVA OD, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Aug 2009 (16 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 22 Oct 2012 (12 years ago) |
| Document Number: | P09000068972 |
| FEI/EIN Number | 270756541 |
| Address: | 8810 NW 155TH TERR, MIAMI LAKES, FL, 33018, US |
| Mail Address: | 8810 NW 155 TER, MIAMI LAKES, FL, 33018, US |
| ZIP code: | 33018 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356791362 | 2016-06-21 | 2018-05-26 | 8810 NW 155TH TER, MIAMI LAKES, FL, 330181411, US | 9729 NW 41ST ST # 23, DORAL, FL, 33178, US | |||||||||||||||||||||||||||
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| Phone | +1 305-815-9755 |
| Phone | +1 305-470-2777 |
| Fax | 3054702999 |
Authorized person
| Name | CHAUNTEL E DA SILVA |
| Role | PD/OPTOMETRIST |
| Phone | 3054702777 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC4307 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 006682000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DA SILVA CHAUNTEL | Agent | 8810 NW 155TH TERR, MIAMI LAKES, FL, 33018 |
| Name | Role | Address |
|---|---|---|
| DA SILVA CHAUNTEL | President | 8810 NW 155TH TERR, MIAMI LAKES, FL, 33018 |
| Name | Role | Address |
|---|---|---|
| DA SILVA CHAUNTEL | Director | 8810 NW 155TH TERR, MIAMI LAKES, FL, 33018 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000024653 | PREMIER MOBILE EYECARE | EXPIRED | 2016-03-08 | 2021-12-31 | No data | 7088 W 4TH LANE, HIALEAH, FL, 33014 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-18 | 8810 NW 155TH TERR, MIAMI LAKES, FL 33018 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-18 | 8810 NW 155TH TERR, MIAMI LAKES, FL 33018 | No data |
| CHANGE OF MAILING ADDRESS | 2018-04-05 | 8810 NW 155TH TERR, MIAMI LAKES, FL 33018 | No data |
| NAME CHANGE AMENDMENT | 2012-10-22 | CHAUNTEL DA SILVA OD, INC. | No data |
| REINSTATEMENT | 2010-10-12 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-21 |
| ANNUAL REPORT | 2023-04-05 |
| ANNUAL REPORT | 2022-02-24 |
| ANNUAL REPORT | 2021-04-13 |
| ANNUAL REPORT | 2020-05-26 |
| ANNUAL REPORT | 2019-04-18 |
| ANNUAL REPORT | 2018-01-05 |
| ANNUAL REPORT | 2017-03-26 |
| ANNUAL REPORT | 2016-03-08 |
| ANNUAL REPORT | 2015-03-16 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
