Healthcare Provider Details
I. General information
NPI: 1174333652
Provider Name (Legal Business Name): BRIGHTER DAY FL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/08/2025
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1041 BROADWAY
WOODMERE NY
11598-1227
US
IV. Provider business mailing address
160 W CAMINO REAL # 1036
BOCA RATON FL
33432-5942
US
V. Phone/Fax
- Phone: 203-568-6065
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVEN
ZAUDERER
Title or Position: OWNER
Credential:
Phone: 203-568-6065