Organization · NPI-2

Bright Light Institute LLC

Family Medicine · Miami Beach, FL

NPI number1295764348
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1295764348
Entity type
Organization (NPI-2)
Legal business name
Bright Light Institute LLC
Organization subpart
No
Enumeration date
Jul 1, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineHCC5405FLYes

Practice location

1106 Normandy Dr
Miami Beach, FL 33141-2812

Phone 305-864-9432 · Fax 305-864-9423

Mailing address

1106 Normandy Dr
Miami Beach, FL 33141-2812

Phone 305-864-9432 · Fax 305-864-9423

Authorized official

Joel Corredor
President
3058649432

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