| Entity Name: | ROUSE FAMILY EYE CARE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 07 Apr 1994 (31 years ago) |
| Document Number: | P94000026593 |
| FEI/EIN Number | 65-0482069 |
| Address: | 15916 W STATE ROAD 84, SUNRISE, FL 33326 |
| Mail Address: | 15916 W STATE ROAD 84, SUNRISE, FL 33326 |
| ZIP code: | 33326 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326352774 | 2010-07-27 | 2021-08-04 | 15916 W STATE ROAD 84, SUNRISE, FL, 333261226, US | 15916 W STATE ROAD 84, SUNRISE, FL, 333261226, US | |||||||||||||||||||||||||
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| Phone | +1 954-384-6200 |
| Fax | 9543840506 |
Authorized person
| Name | DR. DAVID WAYNE ROUSE |
| Role | OWNER |
| Phone | 9543846200 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC 2683 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 086891400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Manne, Grace | Agent | 1792 Bell Tower Lane, Weston, FL 33326 |
| Name | Role | Address |
|---|---|---|
| ROUSE, LINDA SO.D. | Director | 10712 INDIAN TRAIL, COOPER CITY, FL 33328 |
| ROUSE, DAVID WO.D. | Director | 10712 INDIAN TRAIL, COOPER CITY, FL 33328 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-01-11 | Manne, Grace | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-11 | 1792 Bell Tower Lane, Weston, FL 33326 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-01-29 | 15916 W STATE ROAD 84, SUNRISE, FL 33326 | No data |
| CHANGE OF MAILING ADDRESS | 2013-01-29 | 15916 W STATE ROAD 84, SUNRISE, FL 33326 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-12 |
| AMENDED ANNUAL REPORT | 2024-01-11 |
| ANNUAL REPORT | 2024-01-09 |
| ANNUAL REPORT | 2023-02-11 |
| ANNUAL REPORT | 2022-01-29 |
| ANNUAL REPORT | 2021-01-16 |
| ANNUAL REPORT | 2020-01-19 |
| ANNUAL REPORT | 2019-03-25 |
| ANNUAL REPORT | 2018-03-15 |
| ANNUAL REPORT | 2017-01-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
