| Entity Name: | LAKESIDE OPTICAL, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 28 Jan 1993 (32 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P93000007240 |
| FEI/EIN Number | 59-3159906 |
| Mail Address: | 6595 SEMINOLE BLVD, SEMINOLE, FL 33772 |
| Address: | 6595 SEMINOLE BLVD., SEMINOLE, FL 33772 |
| ZIP code: | 33772 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699712067 | 2006-06-02 | 2012-02-01 | 6595 SEMINOLE BLVD, SEMINOLE, FL, 337726314, US | 6595 SEMINOLE BLVD, SEMINOLE, FL, 337726314, US | |||||||||||||||||||||||||||||
|
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| Phone | +1 727-398-7500 |
| Fax | 7273984851 |
Authorized person
| Name | BETHANY KAY ALLEN |
| Role | PRESIDENT |
| Phone | 7273987500 |
Taxonomy
| Taxonomy Code | 156FX1800X - Optician |
| License Number | OE 0000300 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BC/BS FL SUPPLIER NUMBER |
| Number | D7661 |
| State | FL |
| Issuer | PALMETTO EDI SUBMITTER # |
| Number | C08421572 |
| Name | Role | Address |
|---|---|---|
| ALLEN, BETHANY K | Agent | 10085 ASHLEY DR, SEMINOLE, FL 33772 |
| Name | Role | Address |
|---|---|---|
| ALLEN, BETHANY K | President | 10085 ASHLEY DR, SEMINOLE, FL 33772 |
| Name | Role | Address |
|---|---|---|
| ALLEN, BETHANY K | Director | 10085 ASHLEY DR, SEMINOLE, FL 33772 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2016-01-22 | 6595 SEMINOLE BLVD., SEMINOLE, FL 33772 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-01-22 | 10085 ASHLEY DR, SEMINOLE, FL 33772 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-02-02 | 6595 SEMINOLE BLVD., SEMINOLE, FL 33772 | No data |
| REGISTERED AGENT NAME CHANGED | 1999-03-31 | ALLEN, BETHANY K | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-04-09 |
| ANNUAL REPORT | 2017-04-06 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-01-13 |
| ANNUAL REPORT | 2014-01-15 |
| ANNUAL REPORT | 2013-03-15 |
| ANNUAL REPORT | 2012-02-02 |
| ANNUAL REPORT | 2011-01-27 |
| ANNUAL REPORT | 2010-01-25 |
| ANNUAL REPORT | 2009-01-20 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
