Healthcare Provider Details

I. General information

NPI: 1306545579
Provider Name (Legal Business Name): BRILLIANT CLINICAL SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 OAKFIELD DR
BRANDON FL
33511-5743
US

IV. Provider business mailing address

522 OAKFIELD DR
BRANDON FL
33511-5743
US

V. Phone/Fax

Practice location:
  • Phone: 813-588-9088
  • Fax: 813-736-2690
Mailing address:
  • Phone: 813-588-9088
  • Fax: 813-736-2690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALISHA CORNELL BRILL BEARD
Title or Position: OWNER/CLINICIAN
Credential: LCSW
Phone: 813-588-9088