Healthcare Provider Details

I. General information

NPI: 1609714054
Provider Name (Legal Business Name): BRIGHT CLARITY MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3592 ALOMA AVE STE 5
WINTER PARK FL
32792-4012
US

IV. Provider business mailing address

3592 ALOMA AVE STE 5
WINTER PARK FL
32792-4012
US

V. Phone/Fax

Practice location:
  • Phone: 571-230-3394
  • Fax:
Mailing address:
  • Phone: 571-230-3394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LEYDI DOMINGUEZ
Title or Position: MANAGING MEMBER
Credential: MSN,APRN,PMHNP-BC
Phone: 571-230-3394