| Entity Name: | ANNELINE KINGSLEY, MD P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 03 Jun 2013 (12 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | P13000048205 |
| FEI/EIN Number | 46-2939764 |
| Address: | 4217 BAYMEADOWS RD., SUITE 3, JACKSONVILLE, FL, 32217 |
| Mail Address: | 4217 BAYMEADOWS RD., SUITE 3, JACKSONVILLE, FL, 32217 |
| ZIP code: | 32217 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629402441 | 2013-08-28 | 2013-09-16 | 4217 BAYMEADOWS RD, SUITE 3, JACKSONVILLE, FL, 322174676, US | 4217 BAYMEADOWS RD, SUITE 3, JACKSONVILLE, FL, 322174676, US | |||||||||||||||||||
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| Phone | +1 904-332-7431 |
| Fax | 9043327408 |
Authorized person
| Name | ANNELINE KINGSLEY |
| Role | GERIATRIC PSYCHIATRIST |
| Phone | 9043327431 |
Taxonomy
| Taxonomy Code | 2084P0805X - Geriatric Psychiatry Physician |
| License Number | ME114295 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KINGSLEY ANNELINE | Agent | 4217 BAYMEADOWS RD., SUITE 3, JACKSONVILLE, FL, 32217 |
| Name | Role | Address |
|---|---|---|
| KINGSLEY ANNELINE | President | 4217 BAYMEADOWS RD., SUITE 3, JACKSONVILLE, FL, 32217 |
| Name | Role | Address |
|---|---|---|
| KINGSLEY ANNELINE | Director | 4217 BAYMEADOWS RD., SUITE 3, JACKSONVILLE, FL, 32217 |
| Name | Role | Address |
|---|---|---|
| KINGSLEY ANNELINE | Secretary | 4217 BAYMEADOWS RD., SUITE 3, JACKSONVILLE, FL, 32217 |
| Name | Role | Address |
|---|---|---|
| KINGSLEY ANNELINE | Treasurer | 4217 BAYMEADOWS RD., SUITE 3, JACKSONVILLE, FL, 32217 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-01-11 |
| ANNUAL REPORT | 2014-01-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
