Provider Demographics
NPI:1689283467
Name:FAZE 1 INTERNATIONAL INCORPORATED
Entity Type:Organization
Organization Name:FAZE 1 INTERNATIONAL INCORPORATED
Other - Org Name:FAZE 1 MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIJIOKE
Authorized Official - Middle Name:HORACE
Authorized Official - Last Name:NWACHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-333-9749
Mailing Address - Street 1:1661 BIG OAK LN
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-3805
Mailing Address - Country:US
Mailing Address - Phone:786-333-9749
Mailing Address - Fax:
Practice Address - Street 1:200 N JOHN YOUNG PKWY STE 201C
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-6601
Practice Address - Country:US
Practice Address - Phone:407-369-9109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAZE 1 INTERNATIONAL INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-28
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies