Healthcare Provider Details

I. General information

NPI: 1306520804
Provider Name (Legal Business Name): BRIGHT U LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 NW 106TH ST STE 108
MEDLEY FL
33178-1241
US

IV. Provider business mailing address

915 WESTWARD DR
MIAMI SPRINGS FL
33166-5165
US

V. Phone/Fax

Practice location:
  • Phone: 305-763-1343
  • Fax:
Mailing address:
  • Phone: 305-763-1343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LIANETTE PADILLA
Title or Position: OWNER
Credential:
Phone: 305-763-1343