Healthcare Provider Details

I. General information

NPI: 1740113463
Provider Name (Legal Business Name): 1VIZION GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2843 FILLMORE ST APT 102
HOLLYWOOD FL
33020-4252
US

IV. Provider business mailing address

2843 FILLMORE ST APT 102
HOLLYWOOD FL
33020-4252
US

V. Phone/Fax

Practice location:
  • Phone: 786-687-2420
  • Fax:
Mailing address:
  • Phone: 786-687-2420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY BRAZZLE
Title or Position: DIRECTOR
Credential:
Phone: 786-687-2420