| Entity Name: | DR. SHAY RIDGE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Apr 2014 (11 years ago) |
| Document Number: | L14000057502 |
| FEI/EIN Number | 46-5327314 |
| Address: | 710 94th Avenue North, St. Petersburg, FL, 33702, US |
| Mail Address: | 710 94th Avenue North, St. Petersburg, FL, 33702, US |
| ZIP code: | 33702 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1841667219 | 2015-09-01 | 2015-09-01 | 405 SEMINOLE BLVD, LARGO, FL, 337703620, US | 405 SEMINOLE BLVD, LARGO, FL, 337703620, US | |||||||||||||||||||||||||
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| Phone | +1 727-581-7429 |
| Fax | 7275813199 |
Authorized person
| Name | DR. SHAY DAVID RIDGE |
| Role | OWNER OPERATOR CHIROPRACTOR |
| Phone | 7275817429 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH10568 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | HE005Z |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RIDGE SHAY DDR. | Agent | 710 94th Avenue North, St. Petersburg, FL, 33702 |
| Name | Role | Address |
|---|---|---|
| RIDGE SHAY D | Managing Member | 710 94th Avenue North, St. Petersburg, FL, 33702 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000019199 | UNIFY CHIROPRACTIC | ACTIVE | 2023-02-09 | 2028-12-31 | No data | 710 94TH AVE N, SUITE 303, ST PETERSBURG, FL, 33702 |
| G17000097142 | UNIFY CHIROPRACTIC | EXPIRED | 2017-08-28 | 2022-12-31 | No data | 710 94TH AVENUE NORTH, SUITE 303, ST. PETERSBURG, FL, 33702 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-30 | 710 94th Avenue North, Suite 303, St. Petersburg, FL 33702 | No data |
| CHANGE OF MAILING ADDRESS | 2018-04-30 | 710 94th Avenue North, Suite 303, St. Petersburg, FL 33702 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-30 | 710 94th Avenue North, Suite 303, St. Petersburg, FL 33702 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-05-05 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-03-28 |
| ANNUAL REPORT | 2016-03-31 |
| ANNUAL REPORT | 2015-04-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
