Organization Active NPI

Brightside Therapy, LLC.

  • Speech-Language Pathologist
  • Winter Haven, FL
National Provider Identifier
1174197073
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
BRIGHTSIDE THERAPY, LLC.
Practice address
7512 Cypress Gardens Blvd
Winter Haven, FL 33884-3200
Phone
(321) 337-6243
Fax
(352) 717-6829
NPI assigned
May 14, 2021
Last updated
Dec 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Isabella MartinezNPI 1679165617
Title
Speech Language Pathologist
Phone
(321) 337-6243

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

7512 Cypress Gardens Blvd
Winter Haven, FL 33884-3200

Mailing address

7512 Cypress Gardens Blvd
Winter Haven, FL 33884-3200

Other practice location 1

501 E Main St Ste 4
Haines City, FL 33844-4244
Phone (407) 452-9651

Other practice location 2

535 Aster Dr
Davenport, FL 33897-3814
Phone (321) 337-6243

National Provider Directory

National Provider Directory

Locations

501 E Main St
Ste 4
Haines City, FL 33844
Phone (407) 452-9651

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1174197073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7512 CYPRESS GARDENS BLVD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843200",
            "fax_number": "352-717-6829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7512 CYPRESS GARDENS BLVD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843200",
            "telephone_number": "321-337-6243",
            "fax_number": "352-717-6829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 E Main St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Haines City",
            "state": "FL",
            "postal_code": "338444244",
            "country_code": "US",
            "telephone_number": "407-452-9651",
            "fax_number": "352-717-6829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "535 Aster Dr",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "FL",
            "postal_code": "338973814",
            "country_code": "US",
            "telephone_number": "321-337-6243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRIGHTSIDE THERAPY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-14",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "ISABELLA",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "321-337-6243"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.