MEDICARE: BRIGHT SUN THERAPY CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497405450
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT SUN THERAPY CORP

Provider Business Mailing Address
First Line	:	9940 JAMAICA DR
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33189-1718
Country	:	US
Telephone Number	:	786-587-5599
Fax Number	:

Provider Business Practice Location Address
First Line	:	9245 SW 158TH LN FL 3
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-1804
Country	:	US
Telephone Number	:	786-587-5599
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LUIS O CORDERO
Credential	:
Telephone Number	:	786-587-5599

Provider Enumeration Date	:	03/24/2022
Last Update Date	:	01/18/2024

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Directions to “BRIGHT SUN THERAPY CORP ” Practice Location

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