MEDICARE: BRIGHT FUTURE OF NORTH FLORIDA, LLC

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1841141108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT FUTURE OF NORTH FLORIDA, LLC

Provider Business Mailing Address
First Line	:	528 MARQUESA CIR
Second Line	:
City	:	SAINT JOHNS
State	:	FL
Zip	:	32259-2380
Country	:	US
Telephone Number	:	904-201-9050
Fax Number	:	904-661-0021

Provider Business Practice Location Address
First Line	:	528 MARQUESA CIR
Second Line	:
City	:	SAINT JOHNS
State	:	FL
Zip	:	32259-2380
Country	:	US
Telephone Number	:	904-201-9050
Fax Number	:	904-661-0021

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JACQUELINE HENSCHKE
Credential	:	M.D.
Telephone Number	:	904-201-9050

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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