| Bright Young Minds Llc | |
|
2614 Nw 97th Ave Doral FL 33172-1413 | |
| (786) 587-3038 | |
| Not Available |
| Full Name | Bright Young Minds Llc |
|---|---|
| Speciality | Counselor |
| Location | 2614 Nw 97th Ave, Doral, Florida |
| Authorized Official Name and Position | Lissy Sanchez (MEMBER) |
| Authorized Official Contact | 7865873038 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Young Minds Llc 2614 Nw 97th Ave Doral FL 33172-1413 Ph: () - | Bright Young Minds Llc 2614 Nw 97th Ave Doral FL 33172-1413 Ph: (786) 587-3038 |
| NPI Number | 1114536661 |
|---|---|
| Provider Enumeration Date | 07/29/2020 |
| Last Update Date | 07/29/2020 |
| Certification Date | 07/29/2020 |
| Medicare PECOS PAC ID | 7618389628 |
|---|---|
| Medicare Enrollment ID | O20231101001685 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114536661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Gerardo Minsal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982606117 PECOS PAC ID: 5496777104 Enrollment ID: I20051222000026 |
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