Provider Demographics
NPI:1942743455
Name:BRIGHT HEALTH INC.
Entity Type:Organization
Organization Name:BRIGHT HEALTH INC.
Other - Org Name:BRIGHT HEALTH INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRIMARY CARE/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ISMAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLIS-RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-624-6363
Mailing Address - Street 1:2285 ASBURY RD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-5075
Mailing Address - Country:US
Mailing Address - Phone:850-890-3228
Mailing Address - Fax:
Practice Address - Street 1:933 N WOODLAND BLVD
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-2734
Practice Address - Country:US
Practice Address - Phone:386-624-6363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004500200Medicaid
FLIA5857Medicare UPIN