Organization
BRIGHTSIDE PEDIATRICS
Active
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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