Provider Demographics
NPI:1346872777
Name:MIRAID, LLC
Entity Type:Organization
Organization Name:MIRAID, LLC
Other - Org Name:BRIGHTSTAR CARE OF SPRING HILL - CITRUS SPRINGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:COFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:352-587-0321
Mailing Address - Street 1:1275 KASS CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-4308
Mailing Address - Country:US
Mailing Address - Phone:352-587-0321
Mailing Address - Fax:352-616-1650
Practice Address - Street 1:19723 DEER LAKE RD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-7203
Practice Address - Country:US
Practice Address - Phone:603-998-0342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health