MEDICARE: BRILLIANCE BEHAVIOR INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1861337040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRILLIANCE BEHAVIOR INC

Provider Business Mailing Address
First Line	:	7726 WINEGARD RD FL 2
Second Line	:	STE 53
City	:	ORLANDO
State	:	FL
Zip	:	32809-7147
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7726 WINEGARD RD FL 2
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-7147
Country	:	US
Telephone Number	:	305-772-2434
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	REBECA L REYES PEREZ
Credential	:
Telephone Number	:	305-772-2434

Provider Enumeration Date	:	04/22/2026
Last Update Date	:	04/22/2026

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