Provider Demographics
NPI:1992245955
Name:BRIGHT START THERAPY INC
Entity type:Organization
Organization Name:BRIGHT START THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:772-240-9326
Mailing Address - Street 1:162 NE 25TH ST
Mailing Address - Street 2:APT #714
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-4845
Mailing Address - Country:US
Mailing Address - Phone:772-240-9326
Mailing Address - Fax:
Practice Address - Street 1:162 NE 25TH ST
Practice Address - Street 2:APT #714
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-4845
Practice Address - Country:US
Practice Address - Phone:772-240-9326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 15017225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty