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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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