| Entity Name: | FAMILY EYE CARE OF OKEECHOBEE PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 May 2018 (7 years ago) |
| Document Number: | P18000046381 |
| FEI/EIN Number | 83-0643781 |
| Address: | 710 S PARROTT AVE., OKEECHOBEE, FL, 34974, US |
| Mail Address: | 710 S PARROTT AVE., OKEECHOBEE, FL, 34974, US |
| ZIP code: | 34974 |
| County: | Okeechobee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992297444 | 2018-05-31 | 2018-11-07 | 710 S PARROTT AVE, OKEECHOBEE, FL, 349745138, US | 710 S PARROTT AVE, OKEECHOBEE, FL, 349745138, US | |||||||||||||||||||||||||
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| Phone | +1 863-467-0595 |
| Fax | 8634671686 |
Authorized person
| Name | DR. CHRISTINE BISHOP |
| Role | OWNER/OPERATOR |
| Phone | 8634670595 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC4298 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000488100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BISHOP CHRISTINE B | Agent | 6688 SW 21ST PARKWAY, OKEECHOBEE, FL, 34974 |
| Name | Role | Address |
|---|---|---|
| BISHOP CHRISTINE B | President | 710 S PARROTT AVE., OKEECHOBEE, FL, 34974 |
| Name | Role | Address |
|---|---|---|
| BISHOP CHRISTINE B | Secretary | 710 S PARROTT AVE., OKEECHOBEE, FL, 34974 |
| Name | Role | Address |
|---|---|---|
| BISHOP CHRISTINE B | Treasurer | 710 S PARROTT AVE., OKEECHOBEE, FL, 34974 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000062149 | BRENNAN EYE CARE | ACTIVE | 2018-05-24 | 2028-12-31 | No data | 710 S PARROTT AVE, OKEECHOBEE, FL, 34974 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-15 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-01-06 |
| ANNUAL REPORT | 2019-04-03 |
| Domestic Profit | 2018-05-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
