Brightside Behavioral Center Inc

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BRIGHTSIDE BEHAVIORAL CENTER INC

Practice address

1750 W Broadway St Ste 120
Oviedo, FL 32765-9618

Phone

(786) 715-3175

NPI assigned

Aug 23, 2022

Organization subpart

No

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

Authorized official

Name

Anniet Jorge GomezNPI 1740980135

Title

Administrator

Phone

(913) 952-4162

Specialties & licenses 1

Addresses

Other names 1

• BRIGHTSIDE BEHAVIORAL CENTER INC Former legal business name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anniet Jorge Gomez, RBT

  • Behavior Technician
  • Orlando, FL
  • NPI 1740980135
  NPD Authorized official
• Solangel Padron, BCBA

  • Behavior Analyst
  • Gainesville, FL
  • NPI 1780108621
  NPD (past)

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1255050357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11037 SITING PL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328257227",
            "telephone_number": "786-715-3175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 W BROADWAY ST STE 120",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327659618",
            "telephone_number": "786-715-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTSIDE BEHAVIORAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "JORGE GOMEZ",
        "authorized_official_first_name": "ANNIET",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "913-952-4162"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRIGHTSIDE BEHAVIORAL CENTER INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Samir Brahmbhatt, RPH
• James Branch, ATC, LAT
• Christine L Braun, M.S.
• Brian L Weinert DDS PA
• Stephanie Brick, COTA
• Eugene David Brinkley Jr., DDS
• Britta Boekamp Psy D LLC
• Madalyn Coyle Brock
• Desirae Brooks
• Kylie Broskus, PA-C

• Behavior Analyst in Oviedo, FL
• Providers in Oviedo, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.