Healthcare Provider Details
I. General information
NPI: 1083548077
Provider Name (Legal Business Name): BRILLIANT KIDS BEHAVIORAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1130 S POWERLINE RD UNIT 101F
DEERFIELD BEACH FL
33442-8174
US
IV. Provider business mailing address
1130 S POWERLINE RD UNIT 101F
DEERFIELD BEACH FL
33442-8174
US
V. Phone/Fax
- Phone: 754-201-6864
- Fax:
- Phone: 754-201-6864
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 224Z00000X |
| Taxonomy | Occupational Therapy Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RACHEL
PICO PEREZ
Title or Position: OWNER
Credential:
Phone: 754-201-6864