Brilliant Dream Corp

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BRILLIANT DREAM CORP

Practice address

648 NE 5TH Way
Florida City, FL 33034-3261

Phone

(786) 317-1445

NPI assigned

Jun 6, 2023

Organization subpart

No

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

Authorized official

Name

Yahima Carrillo, RBT

Title

Owner

Phone

(786) 317-1445

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1992499602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 NE 5TH WAY",
            "city": "FLORIDA CITY",
            "state": "FL",
            "postal_code": "330343261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 NE 5TH WAY",
            "city": "FLORIDA CITY",
            "state": "FL",
            "postal_code": "330343261",
            "telephone_number": "786-317-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRILLIANT DREAM CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "YAHIMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-317-1445",
        "authorized_official_credential": "RBT"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.