Provider Demographics
NPI:1134403330
Name:BRILLIANT EYECARE, INC.
Entity type:Organization
Organization Name:BRILLIANT EYECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZURIANY
Authorized Official - Middle Name:IVELISSES
Authorized Official - Last Name:OLIVE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-609-8385
Mailing Address - Street 1:8228 SW 190TH TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7540
Mailing Address - Country:US
Mailing Address - Phone:305-253-9038
Mailing Address - Fax:305-971-2577
Practice Address - Street 1:7875 SW 104TH ST STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-2642
Practice Address - Country:US
Practice Address - Phone:305-253-9038
Practice Address - Fax:786-254-1049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2020-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4544152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty