| Entity Name: | SHELBY H CLINE MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Sep 2009 (15 years ago) |
| Document Number: | P09000081117 |
| FEI/EIN Number | 271023032 |
| Address: | 101 Whitehall Drive, ST AUGUSTINE, FL, 32086, US |
| Mail Address: | 101 Whitehall Dr, St Augustine, FL, 32086, US |
| ZIP code: | 32086 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902663735 | 2024-02-28 | 2024-10-23 | 101 WHITEHALL DR STE 108, SAINT AUGUSTINE, FL, 320865268, US | 101 WHITEHALL DR STE 108, SAINT AUGUSTINE, FL, 320865268, US | |||||||||||||||||||||||||
|
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| Phone | +1 904-615-1794 |
| Fax | 9043415552 |
| Phone | +1 904-814-2207 |
Authorized person
| Name | JULIE MANUCY |
| Role | OFFICE MANAGER |
| Phone | 9046151794 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| CLINE SHELBY | Agent | 101 Whitehall Drive, ST AUGUSTINE, FL, 32086 |
| Name | Role | Address |
|---|---|---|
| CLINE SHELBY | President | 101 Whitehall Dr, St Augustine, FL, 32086 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000027702 | SUNSHINE PEDIATRICS OF ST AUGUSTINE | ACTIVE | 2024-02-21 | 2029-12-31 | No data | 101 WHITEHALL DRIVE, SUITE 108, SAINT AUGUSTINE, FL, 32086 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-25 | 101 Whitehall Drive, Suite 108, ST AUGUSTINE, FL 32086 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-25 | 101 Whitehall Drive, Suite 108, ST AUGUSTINE, FL 32086 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-25 | 101 Whitehall Drive, Suite 108, ST AUGUSTINE, FL 32086 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-25 |
| ANNUAL REPORT | 2023-04-09 |
| ANNUAL REPORT | 2022-02-09 |
| ANNUAL REPORT | 2021-02-22 |
| ANNUAL REPORT | 2020-02-03 |
| ANNUAL REPORT | 2019-02-20 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-02-03 |
| ANNUAL REPORT | 2016-03-02 |
| ANNUAL REPORT | 2015-02-06 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
