Organization
I.VIZION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY BRAZZLE (PROVIDER RELATIONS MANAGER)
(954) 918-7303
Entity
Organization
Contact information
Practice address
5220 NW 163RD ST, MIAMI LAKES, FL 33014-6226
(786) 687-2420
Mailing address
5220 NW 163RD ST, MIAMI LAKES, FL 33014-6226
(786) 687-2420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
07/27/2021
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