Organization
BRIGHTSIDE PSYCHOLOGY & INTERNAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAMIR MARRERO PSYD (PRESIDENT)
(407) 601-7748
Entity
Organization
Contact information
Practice address
1277 N SEMORAN BLVD, SUITE 107, ORLANDO, FL 32807-3569
(407) 601-7748
(407) 601-7749
Mailing address
1277 N SEMORAN BLVD, SUITE 107, ORLANDO, FL 32807-3569
(407) 601-7748
(407) 601-7749
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH10506
FL
103TC0700X
Clinical Psychologist
Primary
PY7638
FL
103TC0700X
Clinical Psychologist
PY7723
FL
103TC1900X
Counseling Psychologist
PY8298
FL
174400000X
Specialist
ME110882
FL
Other
Enumeration date
12/09/2010
Last updated
02/03/2012
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