Provider Demographics
NPI:1417604257
Name:SHINE BRIGHT THERAPY
Entity Type:Organization
Organization Name:SHINE BRIGHT THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BORR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-854-2462
Mailing Address - Street 1:7355 SW 87TH AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3565
Mailing Address - Country:US
Mailing Address - Phone:305-854-2462
Mailing Address - Fax:786-542-9754
Practice Address - Street 1:7355 SW 87TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3565
Practice Address - Country:US
Practice Address - Phone:305-854-2462
Practice Address - Fax:786-542-9754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty