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  5. BLUE OCEAN DERMATOLOGY, LLC

BLUE OCEAN DERMATOLOGY, LLC - Florida Company Profile

Company Details

Entity Name: BLUE OCEAN DERMATOLOGY, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

BLUE OCEAN DERMATOLOGY, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 15 Jan 2013 (12 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 28 Oct 2013 (11 years ago)
Document Number: L13000007510
FEI/EIN Number 371711187

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 3951 SOUTH NOVA ROAD,, SUITE 3, PORT ORANGE, FL, 32127, US
Mail Address: 3951 SOUTH NOVA ROAD,, SUITE 3, PORT ORANGE, FL, 32127, US
ZIP code: 32127
County: Volusia
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1992045272 2013-02-22 2018-08-13 3951 S NOVA RD, SUITE 3, PORT ORANGE, FL, 321279270, US 3951 S NOVA RD, SUITE 3, PORT ORANGE, FL, 32127, US

Contacts
Phone +1 386-256-1444

Authorized person
Name NITRA H WELCH
Role CFO
Phone 3862561444

Taxonomy
Taxonomy Code 207N00000X - Dermatology Physician
Is Primary Yes
Taxonomy Code 207ND0900X - Dermatopathology Physician
Is Primary No

Other Provider Identifiers
Issuer MEDICAID
Number 008597300
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLUE OCEAN DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2023 371711187 2024-10-25 BLUE OCEAN DERMATOLOGY, LLC 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3862561444
Plan sponsor’s address 3951 S. NOVA RD. SUITE 3, PORT ORANGE, FL, 32127
BLUE OCEAN DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2022 371711187 2023-09-25 BLUE OCEAN DERMATOLOGY, LLC 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3862561444
Plan sponsor’s address 3951 S. NOVA RD. SUITE 3, PORT ORANGE, FL, 32127
BLUE OCEAN DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2021 371711187 2022-07-18 BLUE OCEAN DERMATOLOGY, LLC 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3862561444
Plan sponsor’s address 3951 S NOVA RD., SUITE 3, PORT ORANGE, FL, 32727
BLUE OCEAN DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2020 371711187 2021-09-26 BLUE OCEAN DERMATOLOGY, LLC 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3862561444
Plan sponsor’s address 3951 S NOVA RD., SUITE 3, PORT ORANGE, FL, 32727
BLUE OCEAN DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2019 371711187 2020-10-03 BLUE OCEAN DERMATOLOGY, LLC 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3862561444
Plan sponsor’s address 3951 S NOVA RD., SUITE 3, PORT ORANGE, FL, 32727
BLUE OCEAN DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2018 371711187 2019-09-28 BLUE OCEAN DERMATOLOGY, LLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3862561444
Plan sponsor’s address 3951 S NOVA RD., SUITE 3, PORT ORANGE, FL, 32127
BLUE OCEAN DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2017 371711187 2018-08-31 BLUE OCEAN DERMATOLOGY, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3862561444
Plan sponsor’s address 3951 S NOVA RD., SUITE 3, PORT ORANGE, FL, 32127

Signature of
Role Plan administrator
Date 2018-08-31
Name of individual signing JASON WELCH
Valid signature Filed with authorized/valid electronic signature
BLUE OCEAN DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2016 371711187 2017-10-17 BLUE OCEAN DERMATOLOGY, LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3862561444
Plan sponsor’s address 3951 S NOVA RD., SUITE 3, PORT ORANGE, FL, 32127

Signature of
Role Plan administrator
Date 2017-10-17
Name of individual signing JASON WELCH
Valid signature Filed with authorized/valid electronic signature
BLUE OCEAN DERMATOLOGY, LLC 401(K) PROFIT SHARING PLAN 2015 371711187 2016-10-17 BLUE OCEAN DERMATOLOGY, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3862561444
Plan sponsor’s address 3951 S NOVA RD., SUITE 3, PORT ORANGE, FL, 32127

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing JASON WELCH
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
WELCH JASON Manager 3951 SOUTH NOVA ROAD, SUITE 3, PORT ORANGE, FL, 32127
Welch Nitra Manager 3951 SOUTH NOVA ROAD,, PORT ORANGE, FL, 32127
Sims Munson CPA Agent 319 N. Parrott Ave, Okeechobee, FL, 34972

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G15000102413 DERMATOLOGY ON THE SPOT EXPIRED 2015-10-06 2020-12-31 - 3951 S. NOVA ROAD, PORT ORANGE, FL, 32127

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2025-01-20 Bhuiyan, Amy -
REGISTERED AGENT ADDRESS CHANGED 2025-01-20 3951 SOUTH NOVA ROAD,, SUITE 3, PORT ORANGE, FL 32127 -
REGISTERED AGENT NAME CHANGED 2019-03-21 Sims Munson CPA -
REGISTERED AGENT ADDRESS CHANGED 2018-04-29 319 N. Parrott Ave, Okeechobee, FL 34972 -
LC AMENDMENT 2013-10-28 - -
CHANGE OF MAILING ADDRESS 2013-05-21 3951 SOUTH NOVA ROAD,, SUITE 3, PORT ORANGE, FL 32127 -
CHANGE OF PRINCIPAL ADDRESS 2013-05-21 3951 SOUTH NOVA ROAD,, SUITE 3, PORT ORANGE, FL 32127 -

Documents

Name Date
ANNUAL REPORT 2025-01-20
ANNUAL REPORT 2024-02-15
ANNUAL REPORT 2023-03-08
ANNUAL REPORT 2022-04-07
ANNUAL REPORT 2021-04-19
ANNUAL REPORT 2020-04-28
ANNUAL REPORT 2019-03-21
ANNUAL REPORT 2018-04-29
ANNUAL REPORT 2017-04-06
ANNUAL REPORT 2016-03-27

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
347759094 0419700 2024-09-17 3951 SOUTH NOVA ROAD, PORT ORANGE, FL, 32127
Inspection Type Complaint
Scope Partial
Safety/Health Health
Close Conference 2024-09-17
Case Closed 2024-09-25

Related Activity
Type Complaint
Activity Nr 2179269
Health Yes

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
2715738610 2021-03-15 0491 PPP 3951 S Nova Rd Ste 3, Port Orange, FL, 32127-9268
Loan Status Date 2022-11-18
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 291376
Loan Approval Amount (current) 291376
Undisbursed Amount 0
Franchise Name -
Lender Location ID 121536
Servicing Lender Name Customers Bank
Servicing Lender Address 40 General Warren Blvd, Malvern, PA, 19355
Rural or Urban Indicator U
Hubzone N
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Port Orange, VOLUSIA, FL, 32127-9268
Project Congressional District FL-07
Number of Employees 35
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 121536
Originating Lender Name Customers Bank
Originating Lender Address Malvern, PA
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 295814.49
Forgiveness Paid Date 2022-10-24
1271487103 2020-04-10 0491 PPP 3951 S NOVA RD, PORT ORANGE, FL, 32127-4910
Loan Status Date 2021-08-20
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 337100
Loan Approval Amount (current) 337100
Undisbursed Amount 0
Franchise Name -
Lender Location ID 225134
Servicing Lender Name Truist Bank
Servicing Lender Address 214 N Tryon St, CHARLOTTE, NC, 28202-1078
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address PORT ORANGE, VOLUSIA, FL, 32127-4910
Project Congressional District FL-07
Number of Employees 41
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 225134
Originating Lender Name Truist Bank
Originating Lender Address CHARLOTTE, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 341257.57
Forgiveness Paid Date 2021-07-09

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Sims Munson CPA

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Companies related by address

3951 SOUTH NOVA ROAD,, SUITE 3, PORT ORANGE, FL, 32127, US

JNB HEALTHCARE SOLUTIONS, LLC DERMATOLOGY ON THE SPOT, LLC

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JNB HEALTHCARE SOLUTIONS, LLC DERMATOLOGY ON THE SPOT, LLC

Date of last update: 01 Mar 2025

Sources: Florida Department of State

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