Breanne N Gillis

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

5400 S University Dr Ste 502
Davie, FL 33328-5313

Phone

(888) 875-4039

NPI assigned

Nov 22, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1114636701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 PARK ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330244122",
            "telephone_number": "754-204-2736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 S UNIVERSITY DR STE 502",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285313",
            "telephone_number": "888-875-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "BREANNE",
        "middle_name": "N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Jay Giese, O.D., PH.D.
• Christopher Gil
• Stephanie Eisen Gilfarb, MS, CCC-SLP
• Gillette Neuropsychology, LLC
• Jennifer M. Gillette
• Tiffany L Gillis, A.P.
• Gina V Eaton LCSW PA
• Gina V Eaton, LCSW, PA
• Antonio Ginebra Aguilar
• Ilya Ginzburg, O.D.

• Behavior Technician in Davie, FL
• Providers in Davie, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.