Provider Demographics
NPI:1346472180
Name:BRIGHTSTAR OF SARASOTA AND MANATEE
Entity Type:Organization
Organization Name:BRIGHTSTAR OF SARASOTA AND MANATEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PANDOS
Authorized Official - Suffix:
Authorized Official - Credentials:CMR
Authorized Official - Phone:941-504-7709
Mailing Address - Street 1:1211 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2208
Mailing Address - Country:US
Mailing Address - Phone:941-504-7709
Mailing Address - Fax:
Practice Address - Street 1:1211 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2208
Practice Address - Country:US
Practice Address - Phone:941-504-7709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health