| Entity Name: | CHRISTINE L. BURNS, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 01 Dec 1994 (30 years ago) |
| Date of dissolution: | 26 Feb 2015 (10 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 26 Feb 2015 (10 years ago) |
| Document Number: | P94000087329 |
| FEI/EIN Number | 593285744 |
| Mail Address: | PO BOX 871, CRYSTAL BEACH, FL, 34681, US |
| Address: | 14003 LAKESHORE BLVD., HUDSON, FL, 34667, US |
| ZIP code: | 34667 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689998361 | 2010-03-24 | 2010-08-18 | 900 CARILLON PARKWAY, SUITE 111, ST. PETERSBURG, FL, 337161115, US | 900 CARILLON PARKWAY, SUITE 111, ST. PETERSBURG, FL, 337161115, US | |||||||||||||||||||||||||
|
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| Phone | +1 727-573-2300 |
| Fax | 7275734344 |
Authorized person
| Name | MRS. CHRISTINE L BURNS |
| Role | OWNER |
| Phone | 7275732300 |
Taxonomy
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| License Number | ME0032382 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 046808800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BURNS CHRISTINE LDr. | Agent | 14003 LAKESHORE BLVD., HUDSON, FL, 34667 |
| Name | Role | Address |
|---|---|---|
| BURNS CHRISTINE LDr. | President | BOX 871, 1014 POINTE SEASIDE DRIVE, CRYSTAL BEACH, FL, 34681 |
| Name | Role | Address |
|---|---|---|
| BURNS CHRISTINE LDr. | Vice President | BOX 871, 1014 POINTE SEASIDE DRIVE, CRYSTAL BEACH, FL, 34681 |
| Name | Role | Address |
|---|---|---|
| BURNS CHRISTINE LDr. | Treasurer | BOX 871, 1014 POINTE SEASIDE DRIVE, CRYSTAL BEACH, FL, 34681 |
| Name | Role | Address |
|---|---|---|
| BURNS CHRISTINE LDr. | Secretary | BOX 871, 1014 POINTE SEASIDE DRIVE, CRYSTAL BEACH, FL, 34681 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2015-02-26 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2013-01-30 | BURNS, CHRISTINE L., Dr. | No data |
| CHANGE OF MAILING ADDRESS | 2012-02-14 | 14003 LAKESHORE BLVD., HUDSON, FL 34667 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-21 | 14003 LAKESHORE BLVD., HUDSON, FL 34667 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-21 | 14003 LAKESHORE BLVD., HUDSON, FL 34667 | No data |
| CANCEL ADM DISS/REV | 2004-11-01 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2015-02-26 |
| ANNUAL REPORT | 2014-01-20 |
| ANNUAL REPORT | 2013-01-30 |
| ANNUAL REPORT | 2012-02-14 |
| ANNUAL REPORT | 2011-04-21 |
| ANNUAL REPORT | 2010-04-09 |
| ANNUAL REPORT | 2009-04-05 |
| ANNUAL REPORT | 2008-04-28 |
| ANNUAL REPORT | 2007-05-03 |
| ANNUAL REPORT | 2006-04-24 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
