| Entity Name: | STEPHANIE CORTES OD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 03 Aug 2016 (9 years ago) |
| Document Number: | P16000064430 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 19390 SW 2 ND STREET, PEMBROKE PINES, FL, 33029, US |
| Mail Address: | 706 W Boynton Beach Blvd, Suite 101, boynton beach, FL, 33426, US |
| ZIP code: | 33029 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518509058 | 2019-10-16 | 2024-07-12 | 706 W BOYNTON BEACH BLVD STE 101, BOYNTON BEACH, FL, 334263621, US | 706 W BOYNTON BEACH BLVD, BOYNTON BEACH, FL, 334263649, US | |||||||||||||||||||||||
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| Phone | +1 954-512-0979 |
| Phone | +1 561-732-5665 |
| Fax | 5617389446 |
Authorized person
| Name | DR. STEPHANIE CORTES |
| Role | OPTOMETRIST/OWNER |
| Phone | 9545120979 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI |
| Number | 1205201936 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CORTES STEPHANIE | Agent | 19390 SW 2 ND STREET, PEMBROKE PINES, FL, 33029 |
| Name | Role | Address |
|---|---|---|
| CORTES STEPHANIE | President | 19390 SW 2 ND STREET, PEMBROKE PINES, FL, 33029 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000125754 | CORTES EYE CARE | ACTIVE | 2017-11-14 | 2027-12-31 | No data | 706 W BOYTON BEACH BLVD, SUITE 101, BOYTON BEACH, FL, 33426 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2021-03-15 | 19390 SW 2 ND STREET, PEMBROKE PINES, FL 33029 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-19 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-01-27 |
| ANNUAL REPORT | 2019-04-11 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-04-22 |
| Domestic Profit | 2016-08-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
