Organization
BRIGHT STAR PEDIATRIC AND ADOLECENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA IDEAN RICH ARNP (NURSE PRACTITIONER)
(850) 374-2311
Entity
Organization
Contact information
Practice address
75 BAY GROVE BLVD, FREEPORT, FL 32439-1725
(850) 374-2311
Mailing address
PO BOX 1132, FREEPORT, FL 32439-1132
(850) 374-2311
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2080412
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003-331-800
—
FL
Enumeration date
08/24/2015
Last updated
08/24/2015
Update your record
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