| Entity Name: | FORT MYERS EYE CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 05 Mar 1998 (27 years ago) |
| Date of dissolution: | 27 Jul 2021 (4 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 27 Jul 2021 (4 years ago) |
| Document Number: | P98000021065 |
| FEI/EIN Number | 650820218 |
| Address: | 1537 BRANTLEY ROAD, UNIT A-2, FORT MYERS, FL, 33907 |
| Mail Address: | 1537 BRANTLEY ROAD, UNIT A-2, FORT MYERS, FL, 33907 |
| ZIP code: | 33907 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740480870 | 2007-07-18 | 2008-06-20 | 1537 BRANTLEY RD, UNIT A2, FORT MYERS, FL, 339073923, US | 1537 BRANTLEY RD, UNIT A2, FORT MYERS, FL, 339073923, US | |||||||||||||||||||||||||||||||
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| Phone | +1 239-481-7799 |
| Fax | 2394813739 |
Authorized person
| Name | DR. BRADLEY DAVID MIDDAUGH |
| Role | PRESIDENT |
| Phone | 2394817799 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | OPC0002377 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 078638100 |
| State | FL |
| Issuer | MEDICARE OTHER |
| Number | 410041706 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MIDDAUGH BRADLEY D | Agent | 1537 BRANTLEY ROAD, FORT MYERS, FL, 33907 |
| Name | Role | Address |
|---|---|---|
| MIDDAUGH BRADLEY D | Director | 1537 BRANTLEY ROAD, UNIT A-2, FORT MYERS, FL, 33907 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2021-07-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-02-05 | 1537 BRANTLEY ROAD, UNIT A-2, FORT MYERS, FL 33907 | No data |
| CHANGE OF MAILING ADDRESS | 2009-02-05 | 1537 BRANTLEY ROAD, UNIT A-2, FORT MYERS, FL 33907 | No data |
| REGISTERED AGENT NAME CHANGED | 2009-02-05 | MIDDAUGH, BRADLEY D | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-02-05 | 1537 BRANTLEY ROAD, UNIT A-2, FORT MYERS, FL 33907 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2021-07-27 |
| ANNUAL REPORT | 2020-03-24 |
| ANNUAL REPORT | 2019-04-09 |
| ANNUAL REPORT | 2018-03-23 |
| ANNUAL REPORT | 2017-05-26 |
| ANNUAL REPORT | 2016-03-29 |
| ANNUAL REPORT | 2015-04-22 |
| ANNUAL REPORT | 2014-04-21 |
| ANNUAL REPORT | 2013-04-25 |
| ANNUAL REPORT | 2012-03-20 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6530597001 | 2020-04-07 | 0455 | PPP | 1537 Brantley Road Unit A2, FORT MYERS, FL, 33907-3923 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Feb 2025
Sources: Florida Department of State
