| Entity Name: | EVANS EYE CARE, CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 15 Feb 2016 (9 years ago) |
| Document Number: | P16000014721 |
| FEI/EIN Number | 81-1462680 |
| Address: | 12621 Miramar Pkwy, Pembroke Pines, FL, 33027, US |
| Mail Address: | 235 NW 207 TERRACE, PEMBROKE PINES, FL, 33029, US |
| ZIP code: | 33027 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255815064 | 2018-09-18 | 2018-10-24 | 235 NW 207TH TER, PEMBROKE PINES, FL, 330293506, US | 1711 NE 163RD ST, NORTH MIAMI BEACH, FL, 331624732, US | |||||||||||||||||||||
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| Phone | +1 302-670-4096 |
| Fax | 3059497301 |
Authorized person
| Name | DR. SHANNON EVANS |
| Role | OPTOMETRIST |
| Phone | 3026704096 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 014059500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| EVANS SHANNON M | Agent | 235 NW 207 TERRACE, PEMBROKE PINES, FL, 33029 |
| Name | Role | Address |
|---|---|---|
| EVANS SHANNON M | President | 235 NW 207 TERRACE, PEMBROKE PINES, FL, 33029 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-03 | 12621 Miramar Pkwy, Bay 101, Pembroke Pines, FL 33027 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-02-03 | EVANS, SHANNON M. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-03 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-04-20 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-07-12 |
| ANNUAL REPORT | 2017-04-29 |
| Domestic Profit | 2016-02-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
