# BRIGHT STAR PEDIATRIC AND ADOLECENT CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629445846
- **Authorized official:** MS. LINDA IDEAN RICH ARNP (NURSE PRACTITIONER)
- **Authorized official phone:** (850) 374-2311

## Contact information

- **Practice address:** 75 BAY GROVE BLVD, FREEPORT, FL 32439-1725
- **Practice address phone:** (850) 374-2311
- **Mailing address:** PO BOX 1132, FREEPORT, FL 32439-1132
- **Mailing address phone:** (850) 374-2311

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0200X | Pediatric Nurse Practitioner | 2080412 | FL | Yes |

## Other

- **Enumeration date:** 08/24/2015
- **Last updated:** 08/24/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003-331-800 | — | FL |