| Entity Name: | CENTRAL FLORIDA EYE CLINIC, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 15 Dec 1998 (26 years ago) |
| Document Number: | P98000104402 |
| FEI/EIN Number | 593546272 |
| Address: | 814 GRIFFIN ROAD, LAKELAND, FL, 33805, US |
| Mail Address: | 814 GRIFFIN ROAD, LAKELAND, FL, 33805, US |
| ZIP code: | 33805 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114113685 | 2007-09-19 | 2020-05-04 | 814 GRIFFIN RD, LAKELAND, FL, 338052440, US | 814 GRIFFIN RD, LAKELAND, FL, 338052440, US | |||||||||||||||||||||||||
|
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| Phone | +1 863-686-1010 |
| Fax | 8636880096 |
Authorized person
| Name | KAVITA MULANEY |
| Role | OFFICE MANAGER |
| Phone | 8636861010 |
Taxonomy
| Taxonomy Code | 156FX1100X - Ophthalmic Technician/Technologist |
| License Number | ME0055340 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 063671100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MULANEY JAY | Agent | 814 GRIFFIN RD, LAKELAND, FL, 33805 |
| Name | Role | Address |
|---|---|---|
| MULANEY JAY | Director | 814 GRIFFIN ROAD, LAKELAND, FL, 33805 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G99076900057 | CENTRAL FLORIDA EYE ASSOCIATES | EXPIRED | 1999-03-17 | 2024-12-31 | No data | 814 GRIFFIN ROAD, LAKELAND, FL, 33805 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2009-01-12 | 814 GRIFFIN ROAD, LAKELAND, FL 33805 | No data |
| CHANGE OF MAILING ADDRESS | 2007-01-08 | 814 GRIFFIN ROAD, LAKELAND, FL 33805 | No data |
| REGISTERED AGENT NAME CHANGED | 2002-07-10 | MULANEY, JAY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2002-07-10 | 814 GRIFFIN RD, LAKELAND, FL 33805 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-02-16 |
| ANNUAL REPORT | 2022-03-03 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-04-14 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-02-20 |
| ANNUAL REPORT | 2017-01-25 |
| ANNUAL REPORT | 2016-01-29 |
| ANNUAL REPORT | 2015-01-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
