| Entity Name: | INDIBLU MANAGEMENT, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Feb 2022 (3 years ago) |
| Document Number: | L22000078747 |
| FEI/EIN Number | 88-1552272 |
| Address: | 1425 SW 110TH WAY, DAVIE, FL, 33324, US |
| Mail Address: | 1425 SW 110TH WAY, DAVIE, FL, 33324, US |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891496667 | 2023-03-16 | 2023-03-16 | 1425 SW 110TH WAY, DAVIE, FL, 333247185, US | 1425 SW 110TH WAY, DAVIE, FL, 333247185, US | |||||||||||||||
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| Phone | +1 954-445-9806 |
| Fax | 9543378265 |
Authorized person
| Name | LUCINDA BLUNT |
| Role | EXECUTIVE DIRECTOR |
| Phone | 7542249333 |
Taxonomy
| Taxonomy Code | 302F00000X - Exclusive Provider Organization |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BLUNT CHERISE | Agent | 1425 SW 110TH WAY, DAVIE, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| BLUNT CHERISE | President | 1425 SW 110TH WAY, DAVIE, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| PASCAL REGINALD | Vice President | 1425 SW 110TH WAY, DAVIE, FL, 33324 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-28 |
| ANNUAL REPORT | 2023-05-01 |
| Florida Limited Liability | 2022-02-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
