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General NPI Number Information
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NPI Number | 1184485278
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Entity Type | Organization
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Legal Business Name | BRILLIANT BRAINS BEHAVIOR SERVICES LLC
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Dates
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Enumeration Date | 01/17/2024
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 3970 TAMPA RD STE E
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City | OLDSMAR
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State | FL
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Zip | 34677-3201
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Country | US
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Telephone | 813-934-0266
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Fax |
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Provider Business Mailing Address
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Address Line | 3980 TAMPA RD STE 205S
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City | OLDSMAR
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State | FL
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Zip | 34677-3223
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YORDANY SOCARRAS
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Credential |
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Telephone | 786-343-7819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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