| Entity Name: | L.C. ERBE, O.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 23 Mar 2011 (14 years ago) |
| Document Number: | P11000028824 |
| FEI/EIN Number | 451630045 |
| Address: | 704 SW PORT SAINT LUCIE BLVD, PORT SAINT LUCIE, FL, 34953, US |
| Mail Address: | 704 SW Port Saint Lucie Blvd, PORT SAINT LUCIE, FL, 34953, US |
| ZIP code: | 34953 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487024568 | 2015-10-01 | 2015-10-01 | 474 SW HOMELAND RD, PORT SAINT LUCIE, FL, 349536278, US | 1721 SW GATLIN BLVD, PORT SAINT LUCIE, FL, 349532757, US | |||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 772-873-0037 |
Authorized person
| Name | DR. LYNNE C ERBE |
| Role | OWNER |
| Phone | 7728730037 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC 3336 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 152WP0200X - Pediatric Optometrist |
| License Number | OPC 3336 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 152WS0006X - Sports Vision Optometrist |
| License Number | OPC 3336 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 152WV0400X - Vision Therapy Optometrist |
| License Number | OPC 3336 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 620970000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ERBE LYNNE C | Agent | 474 SW Homeland Road, Port St Lucie, FL, 34953 |
| Name | Role | Address |
|---|---|---|
| Erbe Lynne C | President | 474 SW Homeland Road, Port St Lucie, FL, 34953 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-04-24 | 704 SW PORT SAINT LUCIE BLVD, PORT SAINT LUCIE, FL 34953 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-04-24 | 474 SW Homeland Road, Port St Lucie, FL 34953 | No data |
| CHANGE OF MAILING ADDRESS | 2020-03-03 | 704 SW PORT SAINT LUCIE BLVD, PORT SAINT LUCIE, FL 34953 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-02-10 | ERBE, LYNNE C | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-17 |
| ANNUAL REPORT | 2023-03-15 |
| ANNUAL REPORT | 2022-08-19 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-04-24 |
| ANNUAL REPORT | 2019-04-26 |
| ANNUAL REPORT | 2018-04-03 |
| ANNUAL REPORT | 2017-02-10 |
| ANNUAL REPORT | 2016-04-15 |
| ANNUAL REPORT | 2015-01-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
