| Entity Name: | SHORELINE MEDICAL ADDICTION TREATMENT LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 Jun 2023 (2 years ago) |
| Document Number: | L23000280793 |
| FEI/EIN Number | 93-1845375 |
| Mail Address: | 107 EAST CIRCLE, NEW SMYRNA BEACH, FL, 32169, US |
| Address: | 602 W Indian River Blvd, Unit 2, EDGEWATER, FL, 32132, US |
| ZIP code: | 32132 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659051647 | 2023-07-24 | 2023-07-24 | 107 EAST CIR, NEW SMYRNA BEACH, FL, 321695213, US | 602 W INDIAN RIVER BLVD STE 2, EDGEWATER, FL, 321323500, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 850-339-6808 |
| Phone | +1 386-868-2619 |
Authorized person
| Name | DR. STEPHEN CHARLES VIEL |
| Role | MANAGING PARTNER |
| Phone | 8503396808 |
Taxonomy
| Taxonomy Code | 261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| POLLARI PATRICIA | Agent | 3924 CORAL RIDGE DRIVE, CORAL SPRINGS, FL, 33065 |
| Name | Role | Address |
|---|---|---|
| VIEL STEPHEN C | Authorized Member | 107 EAST CIRCLE, NEW SMYRNA BEACH, FL, 32169 |
| PONTI JAMIE LEE | Authorized Member | 117 AQUA COURT, NEW SMYRNA BEACH, FL, 32168 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-07-28 | 602 W Indian River Blvd, Unit 2, EDGEWATER, FL 32132 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| Florida Limited Liability | 2023-06-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
