Active NPI
Brightstar Lab Pro LLC
- Technician
- Winter Park, FL
National Provider Identifier
1184404824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Technician | 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2313362 | Brightstar Lab Pro LLC | Certificate of waiver | Oct 29, 2026 |
National Provider Directory
National Provider DirectoryLocations
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.