Provider Demographics
NPI:1326545674
Name:BRILLIANCE THERAPY SOLUTIONS INC
Entity Type:Organization
Organization Name:BRILLIANCE THERAPY SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:YASMIN
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-890-3486
Mailing Address - Street 1:2615 RIDGETOP WAY
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-4226
Mailing Address - Country:US
Mailing Address - Phone:813-369-5926
Mailing Address - Fax:
Practice Address - Street 1:2615 RIDGETOP WAY
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-4226
Practice Address - Country:US
Practice Address - Phone:813-369-5926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health