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BLUE MEDICAL INC.

Company Details

Entity Name: BLUE MEDICAL INC.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 19 Oct 2023 (a year ago)
Document Number: P23000074596
FEI/EIN Number 93-4064636
Address: 4651 GREEN PALM LANE, KISSIMMEE, FL 34746
Mail Address: 4651 GREEN PALM LANE, KISSIMMEE, FL 34746
ZIP code: 34746
County: Osceola
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1104666197 2024-05-28 2024-05-28 4651 GREEN PALM LN, KISSIMMEE, FL, 347465991, US 4651 GREEN PALM LN, KISSIMMEE, FL, 347465991, US

Contacts

Phone +1 201-993-1475

Authorized person

Name DR. ERICKSON ANGEN BALDERA GARCES
Role PRIMARY CARE PHYSICIAN
Phone 2019931475

Taxonomy

Taxonomy Code 261QP2300X - Primary Care Clinic/Center
Is Primary Yes

Agent

Name Role Address
BALDERA, ERICKSON A Agent 4651 GREEN PALM LANE, KISSIMMEE, FL 34741

President

Name Role Address
BALDERA, ERICKSON A President 4651 GREEN PALM LANE, KISSIMMEE, FL 34741

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-03-22 4651 GREEN PALM LANE, KISSIMMEE, FL 34746 No data
CHANGE OF MAILING ADDRESS 2024-03-22 4651 GREEN PALM LANE, KISSIMMEE, FL 34746 No data
REGISTERED AGENT ADDRESS CHANGED 2024-03-22 4651 GREEN PALM LANE, KISSIMMEE, FL 34741 No data

Documents

Name Date
ANNUAL REPORT 2024-03-22
Domestic Profit 2023-10-19

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
9955817310 2020-05-03 0455 PPP 3307 CANTRELL ST, HOLIDAY, FL, 34690-1820
Loan Status Date 2021-05-19
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 61000
Loan Approval Amount (current) 61000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone N
LMI Y
Business Age Description Existing or more than 2 years old
Project Address HOLIDAY, PASCO, FL, 34690-1820
Project Congressional District FL-12
Number of Employees 8
NAICS code 561990
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 61551.51
Forgiveness Paid Date 2021-03-31

Date of last update: 09 Feb 2025

Sources: Florida Department of State