MEDICARE: BRIGHT THERAPY SERVICES II, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1114591377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT THERAPY SERVICES II, INC

Provider Business Mailing Address
First Line	:	2300 NW 23RD AVE
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33993-3950
Country	:	US
Telephone Number	:	239-240-3870
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 NW 23RD AVE
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33993-3950
Country	:	US
Telephone Number	:	239-240-3870
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAYANI AGUIRRE
Credential	:
Telephone Number	:	239-240-3870

Provider Enumeration Date	:	05/13/2021
Last Update Date	:	05/13/2021

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