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General NPI Number Information
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NPI Number | 1124908363
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Entity Type | Organization
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Legal Business Name | BRIGHT STARS CLINIC
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 6059 CAMP LEE RD # A
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-5514
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Country | US
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Telephone | 561-220-2952
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Fax |
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Provider Business Mailing Address
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Address Line | 6059 CAMP LEE RD # A
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-5514
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Country | US
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Telephone | 561-220-2952
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | SAMORA CARPIO
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Credential | APRN
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Telephone | 321-271-5551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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