Provider Demographics
NPI:1710437926
Name:FRAAZINC LLC
Entity Type:Organization
Organization Name:FRAAZINC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRAAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYEED
Authorized Official - Suffix:
Authorized Official - Credentials:PO
Authorized Official - Phone:800-454-9454
Mailing Address - Street 1:9019 SOUTHERN BREEZE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9019 SOUTHERN BREEZE DRIVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836
Practice Address - Country:US
Practice Address - Phone:800-454-9454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-12
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3773213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIQ894ZMedicare PIN