Organization
BRAINGEVITYMD
Active
Organization
BRAINGEVITYMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIE FRAZEY MD (MEDICAL DIRECTOR)
(813) 820-1520
Entity
Organization
Contact information
Practice address
9220 OVERLOOK DR, TEMPLE TERRACE, FL 33617-5422
(813) 820-1520
Mailing address
9220 OVERLOOK DR, TEMPLE TERRACE, FL 33617-5422
(813) 820-1520
(949) 864-3647
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/29/2025
Last updated
08/11/2026
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