Healthcare Provider Details

I. General information

NPI: 1225846967
Provider Name (Legal Business Name): BRIGHT MIND HEALTHCARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9849 SW 184TH ST
PALMETTO BAY FL
33157-6934
US

IV. Provider business mailing address

9849 SW 184TH ST
PALMETTO BAY FL
33157-6934
US

V. Phone/Fax

Practice location:
  • Phone: 786-644-5400
  • Fax: 786-644-5404
Mailing address:
  • Phone: 786-644-5400
  • Fax: 786-644-5404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: KAROL COFINO MATOS
Title or Position: OWNER
Credential:
Phone: 786-720-0862