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General NPI Number Information
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NPI Number | 1679081418
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Entity Type | Organization
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Legal Business Name | BRIGHTSTAR FLORIDA OPERATIONS, LLC
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Dates
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Enumeration Date | 01/15/2018
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 725 PRIMERA BLVD STE 125
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City | LAKE MARY
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State | FL
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Zip | 32746-2134
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Country | US
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Telephone | 407-549-3600
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Fax | 407-549-3602
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Provider Business Mailing Address
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Address Line | 2275 HALF DAY RD STE 210
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City | BANNOCKBURN
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State | IL
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Zip | 60015-1274
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Country | US
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Telephone | 847-693-2004
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Fax | 847-693-2048
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOM GILDAY
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Credential |
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Telephone | 847-693-2004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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