Healthcare Provider Details

I. General information

NPI: 1316657661
Provider Name (Legal Business Name): BRIGHT STAR BEHAVIOR SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2022
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 SW 152ND ST STE M
PALMETTO BAY FL
33157-1901
US

IV. Provider business mailing address

8950 SW 152ND ST STE M
PALMETTO BAY FL
33157-2064
US

V. Phone/Fax

Practice location:
  • Phone: 786-542-4690
  • Fax:
Mailing address:
  • Phone: 786-542-4690
  • 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 Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. BELKIS CARDENAS MESA
Title or Position: PRESIDENT
Credential:
Phone: 786-542-4690