Provider Demographics
NPI:1306545579
Name:BRILLIANT CLINICAL SOLUTIONS LLC
Entity type:Organization
Organization Name:BRILLIANT CLINICAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:CORNELL BRILL
Authorized Official - Last Name:BEARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-588-9088
Mailing Address - Street 1:522 OAKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5743
Mailing Address - Country:US
Mailing Address - Phone:813-588-9088
Mailing Address - Fax:813-736-2690
Practice Address - Street 1:522 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5743
Practice Address - Country:US
Practice Address - Phone:813-588-9088
Practice Address - Fax:813-736-2690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1760646178OtherUNKNOWN