Organization Active NPI

Bright Light Institute LLC

  • Family Medicine Physician
  • Miami Beach, FL
National Provider Identifier
1295764348
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
HCC5405 Issued in FL
Legal business name
BRIGHT LIGHT INSTITUTE LLC
Practice address
1106 Normandy Dr
Miami Beach, FL 33141-2812
Phone
(305) 864-9432
Fax
(305) 864-9423
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Joel Corredor
Title
President
Phone
(305) 864-9432

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X HCC5405 FL Primary

Addresses

Primary practice location

1106 Normandy Dr
Miami Beach, FL 33141-2812

Mailing address

1106 Normandy Dr
Miami Beach, FL 33141-2812
Phone (305) 864-9432

National Provider Directory

National Provider Directory

Locations

1106 Normandy Dr
Miami Beach, FL 33141
Phone (305) 864-9432

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295764348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 NORMANDY DR",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331412812",
            "telephone_number": "305-864-9432",
            "fax_number": "305-864-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 NORMANDY DR",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331412812",
            "telephone_number": "305-864-9432",
            "fax_number": "305-864-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT LIGHT INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CORREDOR",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-864-9432"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "HCC5405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.