| Entity Name: | EYE CARE ASSOCIATES OF CENTRAL FLORIDA, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 19 Aug 2013 (11 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 22 Sep 2021 (3 years ago) |
| Document Number: | P13000070510 |
| FEI/EIN Number | 46-3588054 |
| Address: | 15508 West Colonial Dr., Suite 102, Winter Garden, FL, 34787, US |
| Mail Address: | 15508 West Colonial Dr., Suite 102, Winter Garden, FL, 34787, US |
| ZIP code: | 34787 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285028134 | 2015-03-27 | 2022-02-01 | 15508 W COLONIAL DR STE 102, WINTER GARDEN, FL, 347879557, US | 15508 W COLONIAL DR STE 102, WINTER GARDEN, FL, 347879557, US | |||||||||||||||||||||||||
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| Phone | +1 407-798-8880 |
| Fax | 4077988810 |
Authorized person
| Name | DR. ASHLEY ZAK KIMBLE |
| Role | PRESIDENT |
| Phone | 9548494656 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | 4399 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000236600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KIMBLE RAJUAN B | Agent | 14175 Creekbed Circle, Winter Garden, FL, 34787 |
| Name | Role | Address |
|---|---|---|
| KIMBLE ASHLEY ZO.D. | Director | 15508 West Colonial Dr., Winter Garden, FL, 34787 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000130587 | NEW VISION CARE | ACTIVE | 2021-09-29 | 2026-12-31 | No data | PO BOX 785151, WINTER GARDEN, FL, 34787 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-23 | 15508 West Colonial Dr., Suite 102, Winter Garden, FL 34787 | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-23 | 15508 West Colonial Dr., Suite 102, Winter Garden, FL 34787 | No data |
| AMENDMENT | 2021-09-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-01-09 | 14175 Creekbed Circle, Winter Garden, FL 34787 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-01-10 |
| ANNUAL REPORT | 2022-01-23 |
| ANNUAL REPORT | 2021-01-19 |
| ANNUAL REPORT | 2020-01-13 |
| ANNUAL REPORT | 2019-01-02 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-01-05 |
| ANNUAL REPORT | 2016-01-21 |
| ANNUAL REPORT | 2015-01-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
