MEDICARE: BRIGHTEST IDEA, LLC

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	372600000X	Adult Companion

General Provider Information

NPI Number	:	1710572367
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHTEST IDEA, LLC

Provider Business Mailing Address
First Line	:	4455 CONFEDERATE POINT RD APT 13D
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-5735
Country	:	US
Telephone Number	:	904-982-3491
Fax Number	:

Provider Business Practice Location Address
First Line	:	4455 CONFEDERATE POINT RD APT 13D
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-5735
Country	:	US
Telephone Number	:	904-982-3491
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NICOLE S KENT
Credential	:
Telephone Number	:	904-982-3491

Provider Enumeration Date	:	03/05/2021
Last Update Date	:	12/13/2022

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Directions to “BRIGHTEST IDEA, LLC ” Practice Location

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