Healthcare Provider Details

I. General information

NPI: 1225175953
Provider Name (Legal Business Name): HEATHER KATHLEEN BRIGHT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER KATHLEEN FLORENCE DO

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4713 HIGHWAY 90 AMERICAN FAMILY CARE
PACE FL
32571-1403
US

IV. Provider business mailing address

29 CABANISS CRES APT 3
PENSACOLA FL
32508-1086
US

V. Phone/Fax

Practice location:
  • Phone: 185-030-4069
  • Fax:
Mailing address:
  • Phone: 251-288-9311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberDO0000002686
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDO.1541
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number008960
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDO0000002686
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS 12949
License Number StateFL
# 6
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberOS 12949
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: