Organization Active NPI

Brightstar Lab Pro LLC

  • Technician
  • Winter Park, FL
National Provider Identifier
1184404824
Registry record updated Oct 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
TechnicianTaxonomy code 374700000X
Legal business name
BRIGHTSTAR LAB PRO LLC
Practice address
3001 Aloma Ave Ste 126
Winter Park, FL 32792-3752
Phone
(407) 672-1609
NPI assigned
Oct 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2023

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

Authorized official

Name
Reshema Jelks
Title
Ceo
Phone
(407) 672-1609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 374700000X Primary

Addresses

Primary practice location

3001 Aloma Ave Ste 126
Winter Park, FL 32792-3752

Mailing address

3001 Aloma Ave Ste 126
Winter Park, FL 32792-3752

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2313362Brightstar Lab Pro LLC3001 Aloma Ave Ste 126, Winter Park, FL 32792Certificate of waiverOct 29, 2026

National Provider Directory

National Provider Directory

Locations

3001 Aloma Ave
Ste 126
Winter Park, FL 32792
Phone (407) 672-1609

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696636800000",
    "number": "1184404824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 ALOMA AVE STE 126",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 ALOMA AVE STE 126",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923752",
            "telephone_number": "407-672-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTSTAR LAB PRO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-07",
        "certification_date": "2023-10-07",
        "status": "A",
        "authorized_official_last_name": "JELKS",
        "authorized_official_first_name": "RESHEMA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-672-1609"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.