Provider Demographics
NPI:1336311950
Name:EXECUTIVE HEALTHCARE SOLUTIONS
Entity Type:Organization
Organization Name:EXECUTIVE HEALTHCARE SOLUTIONS
Other - Org Name:BRIGHTSTAR HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTSKO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MHA, FACHE
Authorized Official - Phone:239-348-5601
Mailing Address - Street 1:8891 BRIGHTON LANE
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135
Mailing Address - Country:US
Mailing Address - Phone:239-992-4779
Mailing Address - Fax:239-992-4764
Practice Address - Street 1:8891 BRIGHTON LANE
Practice Address - Street 2:SUITE 122
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135
Practice Address - Country:US
Practice Address - Phone:239-992-4779
Practice Address - Fax:239-992-4764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health