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Organization
BRIGHT STAR PEDIATRIC AND ADOLECENT CENTER
Active
Organization
BRIGHT STAR PEDIATRIC AND ADOLECENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA IDEAN RICH ARNP (NURSE PRACTITIONER)
(850) 374-2311
Entity
Organization
Contact information
Practice address
75 BAY GROVE BLVD, FREEPORT, FL 32439-1725
(850) 374-2311
Mailing address
PO BOX 1132, FREEPORT, FL 32439-1132
(850) 374-2311
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2080412
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003-331-800
—
FL
Enumeration date
08/24/2015
Last updated
08/24/2015
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