Florida Bright Minds Therapy LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

FLORIDA BRIGHT MINDS THERAPY LLC

Practice address

2420 N Crystal Lake Dr Ste 303
Lakeland, FL 33801-6205

Phone

(786) 942-8411

NPI assigned

Jun 28, 2024

Last updated

Jun 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adonys Gonzalez

Title

President

Phone

(786) 942-8411

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1861237927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 N CRYSTAL LAKE DR STE 303",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338016205",
            "telephone_number": "786-942-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 N CRYSTAL LAKE DR STE 303",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338016205",
            "telephone_number": "786-942-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA BRIGHT MINDS THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ADONYS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-942-8411"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.