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General NPI Number Information
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NPI Number | 1548074594
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Entity Type | Organization
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Legal Business Name | BRIGHT HORIZONS BEHAVIORAL SERVICES LLC
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Dates
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Enumeration Date | 02/01/2025
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Last Update Date | 02/01/2025
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Provider Practice Location Address
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Address Line | 6121 AVALON RD
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City | WINTER GARDEN
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State | FL
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Zip | 34787-9745
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Country | US
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Telephone | 407-349-7044
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Fax | 800-316-7892
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Provider Business Mailing Address
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Address Line | 6121 AVALON RD
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City | WINTER GARDEN
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State | FL
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Zip | 34787-9745
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Country | US
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Telephone | 407-349-7044
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Fax | 800-316-7892
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Authorized Official
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Title or Position | OWNER
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Name | ENRIQUE MURILLO
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Credential | MD
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Telephone | 915-276-4611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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