| Entity Name: | INTERNATIONAL EYE ASSOCIATES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 20 Jan 1998 (27 years ago) |
| Document Number: | P98000005490 |
| FEI/EIN Number | 59-3487023 |
| Address: | 1545 HAND AVENUE, SUITE B3, ORMOND BEACH, FL 32174 |
| Mail Address: | 1545 HAND AVENUE, SUITE B3, ORMOND BEACH, FL 32174 |
| ZIP code: | 32174 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972524023 | 2006-07-22 | 2009-05-13 | 1545 HAND AVENUE, SUITE B3, ORMOND BEACH, FL, 321741140, US | 1545 HAND AVENUE, SUITE B3, ORMOND BEACH, FL, 321741140, US | |||||||||||||||||||||||||
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| Phone | +1 386-673-3939 |
| Fax | 3866775374 |
Authorized person
| Name | DR. MARK S. RUBIN |
| Role | DOCTOR/OWNER |
| Phone | 3866733939 |
Taxonomy
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| License Number | ME0047655 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 052266000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SHETTY, M.D., RAJESH K. | Agent | 1545 HAND AVENUE, SUITE B3, ORMOND BEACH, FL 32174 |
| Name | Role | Address |
|---|---|---|
| SHETTY, M.D., RAJESH K. | President | 1545 HAND AVENUE - SUITE B3, ORMOND BEACH, FL 32174 |
| Name | Role | Address |
|---|---|---|
| SHETTY, M.D., RAJESH K. | Director | 1545 HAND AVENUE - SUITE B3, ORMOND BEACH, FL 32174 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000136820 | ATLANTIC EYE CENTER | ACTIVE | 2024-11-08 | 2029-12-31 | No data | 3 PINE CONE DRIVE, SUITE 104, PALM COAST, FL, 32134 |
| G99040900046 | INTERNATIONAL EYE ASSOCIATES | EXPIRED | 1999-02-09 | 2024-12-31 | No data | 1545, HAND AVE - SUITE B-3, ORMOND BEACH, FL, 32174 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-05-31 | SHETTY, M.D., RAJESH K. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-01-11 | 1545 HAND AVENUE, SUITE B3, ORMOND BEACH, FL 32174 | No data |
| CHANGE OF MAILING ADDRESS | 2011-01-11 | 1545 HAND AVENUE, SUITE B3, ORMOND BEACH, FL 32174 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-03-31 | 1545 HAND AVENUE, SUITE B3, ORMOND BEACH, FL 32174 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| AMENDED ANNUAL REPORT | 2023-05-31 |
| ANNUAL REPORT | 2023-03-26 |
| ANNUAL REPORT | 2022-03-04 |
| ANNUAL REPORT | 2021-02-02 |
| ANNUAL REPORT | 2020-05-12 |
| ANNUAL REPORT | 2019-03-05 |
| ANNUAL REPORT | 2018-02-07 |
| ANNUAL REPORT | 2017-03-23 |
| ANNUAL REPORT | 2016-02-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
