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BLUESHINE MEDICAL CENTER LLC - Florida Company Profile

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Company Details

Entity Name: BLUESHINE MEDICAL CENTER LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 15 Jul 2024 (a year ago)
Document Number: L24000314343
FEI/EIN Number 99-4037142
Address: 140 SANTA BARBARA BLVD, SUITE 122, CAPE CORAL, FL, 33991, US
Mail Address: 140 SANTA BARBARA BLVD, SUITE 122, CAPE CORAL, FL, 33991, US
ZIP code: 33991
City: Cape Coral
County: Lee
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
ARMENTEROS MARISEL Agent 1911 NW 15TH TER, CAPE CORAL, FL, 33993
- Manager -
- Manager -

National Provider Identifier

NPI Number:
1053138099
Certification Date:
2024-09-22

Authorized Person:

Name:
DR. JOSE GUSTAVO CEVALLOS
Role:
PROVIDER
Phone:

Taxonomy:

Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
Yes

Contacts:

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2025-01-30 140 SANTA BARBARA BLVD, SUITE 122, CAPE CORAL, FL 33991 -
CHANGE OF MAILING ADDRESS 2025-01-30 140 SANTA BARBARA BLVD, SUITE 122, CAPE CORAL, FL 33991 -

Documents

Name Date
ANNUAL REPORT 2025-01-30
Florida Limited Liability 2024-07-15

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Date of last update: 01 Aug 2025

Sources: Florida Department of State