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  5. EYE DOCTORS OPTICAL OUTLET OF POLK, P.A.

EYE DOCTORS OPTICAL OUTLET OF POLK, P.A.

Company Details

Entity Name: EYE DOCTORS OPTICAL OUTLET OF POLK, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 26 Jan 1998 (27 years ago)
Document Number: P98000007886
FEI/EIN Number 593491967
Address: 5607 JOHNS ROAD, TAMPA, FL, 33634
Mail Address: 5607 JOHNS ROAD, TAMPA, FL, 33634
ZIP code: 33634
County: Hillsborough
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
OPTICAL OUTLETS - POLK 401(K) PLAN 2022 593491967 2023-07-14 EYE DOCTORS OPTICAL OUTLET OF POLK, P.A. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-07-01
Business code 446130
Sponsor’s telephone number 8138853937
Plan sponsor’s address 5607 JOHNS ROAD, TAMPA, FL, 33634

Signature of
Role Plan administrator
Date 2023-07-14
Name of individual signing SHERYLE BAINE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-07-14
Name of individual signing SHERYLE BAINE
Valid signature Filed with authorized/valid electronic signature
OPTICAL OUTLETS - POLK 401(K) PLAN 2021 593491967 2022-09-14 EYE DOCTORS OPTICAL OUTLET OF POLK, P.A. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-07-01
Business code 446130
Sponsor’s telephone number 8138853937
Plan sponsor’s address 5607 JOHNS ROAD, TAMPA, FL, 33634

Signature of
Role Plan administrator
Date 2022-09-14
Name of individual signing SHERYLE BAINE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-14
Name of individual signing SHERYLE BAINE
Valid signature Filed with authorized/valid electronic signature
OPTICAL OUTLETS - POLK 401(K) PLAN 2020 593491967 2021-10-07 EYE DOCTORS OPTICAL OUTLET OF POLK, P.A. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-07-01
Business code 446130
Sponsor’s telephone number 8138853937
Plan sponsor’s address 5607 JOHNS ROAD, TAMPA, FL, 33634

Signature of
Role Plan administrator
Date 2021-10-07
Name of individual signing SHERYLE BAINE
Valid signature Filed with authorized/valid electronic signature
OPTICAL OUTLETS - POLK 401(K) PLAN 2019 593491967 2020-09-24 EYE DOCTORS OPTICAL OUTLET OF POLK, P.A. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-07-01
Business code 446130
Sponsor’s telephone number 8138853937
Plan sponsor’s address 5607 JOHNS ROAD, TAMPA, FL, 33634

Signature of
Role Plan administrator
Date 2020-09-24
Name of individual signing SHERYLE BAINE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-09-24
Name of individual signing SHERYLE BAINE
Valid signature Filed with authorized/valid electronic signature
OPTICAL OUTLETS - POLK 401(K) PLAN 2018 593491967 2019-06-21 EYE DOCTORS OPTICAL OUTLET OF POLK, P.A. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-07-01
Business code 446130
Sponsor’s telephone number 8138853937
Plan sponsor’s address 5607 JOHNS ROAD, TAMPA, FL, 33634

Signature of
Role Plan administrator
Date 2019-06-21
Name of individual signing SHERYLE BAINE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BAINE SHERYLE Agent 5607 JOHNS ROAD, TAMPA, FL, 33634

President

Name Role Address
LEWENSON ROBERT President 5607 JOHNS ROAD, TAMPA, FL, 33634

Secretary

Name Role Address
LEWENSON ROBERT Secretary 5607 JOHNS ROAD, TAMPA, FL, 33634

Director

Name Role Address
LEWENSON ROBERT Director 5607 JOHNS ROAD, TAMPA, FL, 33634
RANEY DENNIS B Director 5607 JOHNS ROAD, TAMPA, FL, 33634
ISMAIL ESAAM Director 5607 JOHNS ROAD, TAMPA, FL, 33634

Treasurer

Name Role Address
RANEY DENNIS B Treasurer 5607 JOHNS ROAD, TAMPA, FL, 33634

Vice President

Name Role Address
ISMAIL ESAAM Vice President 5607 JOHNS ROAD, TAMPA, FL, 33634

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G09028900012 EYE DOCTORS OPTICAL OUTLET EXPIRED 2009-01-28 2014-12-31 No data 5709 JOHNS ROAD,SUITE 1209, TAMPA, FL, 33634-4315
G09028900013 EYE DOCTORS OPTICAL OUTLETS EXPIRED 2009-01-28 2014-12-31 No data 5709 JOHNS ROAD,SUITE 1209, TAMPA, FL, 33634-4315
G09028900014 OPTICAL OUTLETS ACTIVE 2009-01-28 2025-12-31 No data 5709 JOHNS ROAD,SUITE 1209, TAMPA, FL, 33634-4315
G94322900025 OPTICAL OUTLET ACTIVE 1994-11-18 2025-12-31 No data 5709 JOHNS ROAD, SUITE 1209, TAMPA, FL, 33634

Events

Event Type Filed Date Value Description
REINSTATEMENT 2000-01-06 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 1999-09-24 No data No data

Related by officers

LEWENSON ROBERT

EYE DOCTORS OPTICAL OUTLET OF BRADENTON, P.A.

RANEY DENNIS B

EYE DOCTORS OPTICAL OUTLET OF LAKELAND, P.A.

ISMAIL ESAAM

SONYA M. BRAUDWAY, P.A. ESAAM ISMAIL, O.D., P.A.

BAINE SHERYLE

EYE DOCTORS OPTICAL OUTLET OF BRADENTON, P.A. EYE DOCTORS OPTICAL OUTLET OF LAKELAND, P.A. EYE DOCTORS OPTICAL OUTLET OF PINELLAS, P.A.

Related by address

5607 JOHNS ROAD, TAMPA, FL, 33634

EYE DOCTORS OPTICAL OUTLET OF BRADENTON, P.A.

5607 JOHNS ROAD, TAMPA, FL, 33634

EYE DOCTORS OPTICAL OUTLET OF BRADENTON, P.A.

Date of last update: 02 Jan 2025

Sources: Florida Department of State

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