Provider Demographics
NPI:1518476795
Name:SEQUELCARE OF FLORIDA LLC
Entity Type:Organization
Organization Name:SEQUELCARE OF FLORIDA LLC
Other - Org Name:BRIGHTER HEIGHTS FLORIDA, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-712-4393
Mailing Address - Street 1:3491 GANDY BLVD N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2658
Mailing Address - Country:US
Mailing Address - Phone:727-547-0607
Mailing Address - Fax:727-547-6752
Practice Address - Street 1:567 NW LAKE WHITNEY PL STE 101
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-1629
Practice Address - Country:US
Practice Address - Phone:772-337-8164
Practice Address - Fax:772-337-8165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-20
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC10070251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management