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BLUEHEALTH MEDICAL GROUP, INC.

Company Details

Entity Name: BLUEHEALTH MEDICAL GROUP, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 06 Jun 2024 (8 months ago)
Document Number: P24000039091
FEI/EIN Number 993458030
Address: 11390 PALM BEACH BLVD, FORT MYERS, FL, 33905, US
Mail Address: 11390 PALM BEACH BLVD, FORT MYERS, FL, 33905, US
ZIP code: 33905
County: Lee
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1871339929 2024-07-08 2024-07-08 11390 PALM BEACH BLVD, FORT MYERS, FL, 339055921, US 11390 PALM BEACH BLVD, FORT MYERS, FL, 339055921, US

Contacts

Phone +1 239-443-7403

Authorized person

Name GUILLERMO DE SANTIS NOYA
Role OWNER
Phone 2394437403

Taxonomy

Taxonomy Code 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary Yes

Agent

Name Role Address
DE SANTIS GUILLERMO SR Agent 11390 PALM BEACH BLVD, FORT MYERS, FL, 33905

Authorized Member

Name Role Address
DE SANTIS GUILLERMO SR Authorized Member 11390 PALM BEACH BLVD UNIT 301A, FORT MYERS, FL, 33905
MARTINEZ ERNESTO Authorized Member 11390 PALM BEACH BLVD, FORT MYERS, FL, 33905

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-08-21 11390 PALM BEACH BLVD, Unit 301A, FORT MYERS, FL 33905 No data
CHANGE OF MAILING ADDRESS 2024-08-21 11390 PALM BEACH BLVD, Unit 301A, FORT MYERS, FL 33905 No data

Documents

Name Date
Domestic Profit 2024-06-06

Date of last update: 01 Feb 2025

Sources: Florida Department of State