Provider Demographics
NPI:1962264820
Name:SAGE ATLAS LLC DBA BRIGHTSTAR CARE OF E. ORLANDO / LAKE NONA
Entity type:Organization
Organization Name:SAGE ATLAS LLC DBA BRIGHTSTAR CARE OF E. ORLANDO / LAKE NONA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIVYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAGAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-340-4790
Mailing Address - Street 1:5449 S SEMORAN BLVD STE 234
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-1779
Mailing Address - Country:US
Mailing Address - Phone:321-340-4790
Mailing Address - Fax:321-233-1530
Practice Address - Street 1:5449 S SEMORAN BLVD STE 234
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-1779
Practice Address - Country:US
Practice Address - Phone:321-340-4790
Practice Address - Fax:321-233-1530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health