Provider Demographics
NPI:1871317586
Name:BRIGHT BAY PSYCHIATRY, LLC
Entity type:Organization
Organization Name:BRIGHT BAY PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:PEYTON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNSWICK
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:813-334-5700
Mailing Address - Street 1:8207 WATER TOWER DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-6624
Mailing Address - Country:US
Mailing Address - Phone:813-334-5700
Mailing Address - Fax:813-537-3809
Practice Address - Street 1:3502 HENDERSON BLVD STE 312
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4087
Practice Address - Country:US
Practice Address - Phone:813-537-8804
Practice Address - Fax:813-537-8804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-09
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty