Provider Demographics
NPI:1659001741
Name:BRIGHT CARE FAMILY MEDICINE CORP
Entity Type:Organization
Organization Name:BRIGHT CARE FAMILY MEDICINE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DMITRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHUKOVSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:786-733-1066
Mailing Address - Street 1:1920 E HALLANDALE BEACH BLVD STE 901
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4726
Mailing Address - Country:US
Mailing Address - Phone:786-733-1066
Mailing Address - Fax:786-839-3258
Practice Address - Street 1:1920 E HALLANDALE BLVD
Practice Address - Street 2:SUITE 901
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009
Practice Address - Country:US
Practice Address - Phone:786-733-1066
Practice Address - Fax:786-839-3258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL113967000Medicaid
FLOS18656OtherDEPARTMENT OF HEALTH OSTEOPATHIC PHYSICIAN LICENSE