Organization
BRIGHT MINDS PEDIATRIC THERAPY LLC.
Active
Organization
BRIGHT MINDS PEDIATRIC THERAPY LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOLEYS GOMEZ (OWNER)
(786) 537-5904
Entity
Organization
Contact information
Practice address
4097 SUSSEX AVE, LAKE WORTH, FL 33461-1719
(786) 537-5904
Mailing address
4097 SUSSEX AVE, LAKE WORTH, FL 33461-1719
(786) 537-5904
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841834736
—
FL
Enumeration date
04/24/2022
Last updated
08/24/2022
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