Blue Medical Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

BLUE MEDICAL INC

Practice address

4651 Green Palm LN
Kissimmee, FL 34746-5991

Phone

(201) 993-1475

NPI assigned

May 28, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Erickson Angen Baldera Garces, MD

Title

Primary Care Physician

Phone

(201) 993-1475

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1104666197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 GREEN PALM LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347465991",
            "telephone_number": "201-993-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 GREEN PALM LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347465991",
            "telephone_number": "201-993-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "BALDERA GARCES",
        "authorized_official_first_name": "ERICKSON",
        "authorized_official_middle_name": "ANGEN",
        "authorized_official_title_or_position": "PRIMARY CARE PHYSICIAN",
        "authorized_official_telephone_number": "201-993-1475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.