MEDICARE: BRIGHT FUTURES SUPPORT

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1942659453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT FUTURES SUPPORT

Provider Business Mailing Address
First Line	:	5747 CROWNTREE LN APT 111
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32829
Country	:	US
Telephone Number	:	407-286-4796
Fax Number	:

Provider Business Practice Location Address
First Line	:	2180 CENTRAL FLORIDA PKWY STE A2
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-8900
Country	:	US
Telephone Number	:	407-286-4796
Fax Number	:

Authorized Official
Title or Position	:	MENTAL HEALTH COUNSELOR
Name	:	YAZNELLY S RIVERA
Credential	:	MSPA, MSCJ, BS
Telephone Number	:	407-508-7374

Provider Enumeration Date	:	06/06/2016
Last Update Date	:	06/06/2016

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Directions to “BRIGHT FUTURES SUPPORT ” Practice Location

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