Healthcare Provider Details

I. General information

NPI: 1093634370
Provider Name (Legal Business Name): SIMPLE BRIDGE SOLUTION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7418 COMMERCE ST
RIVERVIEW FL
33578-4333
US

IV. Provider business mailing address

7418 COMMERCE ST
RIVERVIEW FL
33578-4333
US

V. Phone/Fax

Practice location:
  • Phone: 813-230-5505
  • Fax:
Mailing address:
  • Phone: 813-230-5505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: LUZMARY GONZALEZ
Title or Position: REGISTER MARRIAGE AND FAMILY THERAP
Credential: IMT4144
Phone: 813-230-5505