Provider Demographics
NPI:1285324053
Name:BRIGHT BEHAVIORAL DEVELOPMENT LLC
Entity type:Organization
Organization Name:BRIGHT BEHAVIORAL DEVELOPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:LEONARDO
Authorized Official - Last Name:ZAMORA HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-641-0753
Mailing Address - Street 1:6526 SW 129TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-1389
Mailing Address - Country:US
Mailing Address - Phone:786-641-0753
Mailing Address - Fax:
Practice Address - Street 1:13354 SW 128TH ST STE 201A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5807
Practice Address - Country:US
Practice Address - Phone:786-641-0753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty