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Organization

BRIGHTSIDE PEDIATRICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACQUE DENNIE (OWNER, DIRECTOR OF NURSING)
(904) 895-7337
Entity
Organization

Contact information

Practice address
1764 TREE BLVD STE 1, SAINT AUGUSTINE, FL 32084-5723
(904) 895-7337
(904) 925-1365
Mailing address
1764 TREE BLVD STE 1, SAINT AUGUSTINE, FL 32084-5723
(904) 895-7337
(904) 925-1365

Taxonomy

Speciality
Code
Description
License number
State
261QM3000X
Medically Fragile Infants and Children Day Care
Primary

Other

Enumeration date
09/20/2024
Last updated
09/20/2024
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