MEDICARE: BRIGHT SOLUTIONS THERAPY, 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	174400000X	Specialist	SA13548	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588161491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT SOLUTIONS THERAPY, INC

Provider Business Mailing Address
First Line	:	3429 W 80TH ST APT 108
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-7571
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3429 W 80TH ST APT 108
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-7571
Country	:	US
Telephone Number	:	786-486-9749
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANNIA ROSA PEREZ PINILLO
Credential	:	SLP
Telephone Number	:	786-486-9749

Provider Enumeration Date	:	04/07/2018
Last Update Date	:	04/07/2018

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Directions to “BRIGHT SOLUTIONS THERAPY, INC ” Practice Location

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