| Brightside Behavioral Center Inc | |
|
1750 W Broadway St Ste 120 Oviedo FL 32765-9618 | |
| (786) 715-3175 | |
| Not Available |
| Full Name | Brightside Behavioral Center Inc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1750 W Broadway St Ste 120, Oviedo, Florida |
| Authorized Official Name and Position | Anniet Jorge Gomez (ADMINISTRATOR) |
| Authorized Official Contact | 9139524162 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brightside Behavioral Center Inc 11037 Siting Pl Orlando FL 32825-7227 Ph: (786) 715-3175 | Brightside Behavioral Center Inc 1750 W Broadway St Ste 120 Oviedo FL 32765-9618 Ph: (786) 715-3175 |
| NPI Number | 1255050357 |
|---|---|
| Provider Enumeration Date | 08/23/2022 |
| Last Update Date | 10/12/2022 |
| Certification Date | 10/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255050357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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