| Entity Name: | GABLES VISION OPTICAL, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Dec 1994 (30 years ago) |
| Document Number: | P94000090446 |
| FEI/EIN Number | 650539268 |
| Address: | 1661 SW 37 AVE, SUITE 100, MIAMI, FL, 33145, US |
| Mail Address: | 21170 main sail cr, MIAMI, FL, 33180, US |
| ZIP code: | 33145 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548473721 | 2007-05-07 | 2008-07-15 | 1661 SW 37TH AVE, STE 100, CORAL GABLES, FL, 331451754, US | 1661 SW 37TH AVE, STE 100, CORAL GABLES, FL, 331451754, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 305-447-0702 |
| Fax | 3054470504 |
Authorized person
| Name | ABRAHAM AWAD |
| Role | OPTOMETRIST SOLE PROPRIETOR |
| Phone | 3054470702 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC2717 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 084939100 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 20472 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| AWAD ABRAHAM | Agent | 1661 SW 37 AVE, MIAMI, FL, 33145 |
| Name | Role | Address |
|---|---|---|
| AWAD ABRAHAM | President | 21170 MAIN SAIL CIR C11, AVENTURA, FL, 33180 |
| Name | Role | Address |
|---|---|---|
| AWAD LAYLA | Director | 21170 MAIN SAIL CR C11, AVENTURA, FL, 33180 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
