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General NPI Number Information
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NPI Number | 1871460709
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Entity Type | Organization
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Legal Business Name | BRIGHT STAR MEDICAL GROUP CORP
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Dates
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Enumeration Date | 10/23/2025
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 8249 NW 36TH ST
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City | DORAL
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State | FL
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Zip | 33166-6603
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Country | US
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Telephone | 786-953-6784
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Fax |
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Provider Business Mailing Address
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Address Line | 8249 NW 36TH ST
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City | DORAL
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State | FL
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Zip | 33166-6603
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Country | US
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Telephone | 786-953-6784
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LAKESHA CARTER
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Credential | RN
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Telephone | 362-631-3423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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