| Entity Name: | MIAMI SHORES OPTICAL INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 15 Sep 2009 (15 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | P09000077090 |
| FEI/EIN Number | 270944247 |
| Address: | 9440 NE 2ND AVE, MIAMI, FL, 33138 |
| Mail Address: | 9440 NE 2ND AVE, MIAMI, FL, 33138 |
| ZIP code: | 33138 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831466358 | 2011-11-29 | 2011-11-29 | 9440 NE 2ND AVE, MIAMI SHORES, FL, 331382703, US | 9440 NE 2ND AVE, MIAMI SHORES, FL, 331382703, US | |||||||||||||||||||||||||
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| Phone | +1 786-313-3048 |
| Fax | 7863133051 |
Authorized person
| Name | DR. COURTNEY CONSTANTINE WILLIAMS |
| Role | OWNER/OPTOMETRIST |
| Phone | 7863133048 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC 3388 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 620628000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WILLIAMS COURTNEY | Agent | 9440 NE 2ND AVE, MIAMI, FL, 33138 |
| Name | Role | Address |
|---|---|---|
| WILLIAMS COURTNEY | President | 9440 NE 2ND, MIAMI, FL, 33138 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-08-31 | 9440 NE 2ND AVE, MIAMI, FL 33138 | No data |
| CHANGE OF MAILING ADDRESS | 2012-08-31 | 9440 NE 2ND AVE, MIAMI, FL 33138 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-08-31 | 9440 NE 2ND AVE, MIAMI, FL 33138 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-09-27 |
| ANNUAL REPORT | 2012-08-31 |
| ANNUAL REPORT | 2011-04-28 |
| ANNUAL REPORT | 2010-04-30 |
| Domestic Profit | 2009-09-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
