Provider Demographics
NPI:1538146675
Name:EZ HEALTH MEDICAL CENTER INC
Entity type:Organization
Organization Name:EZ HEALTH MEDICAL CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEONEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ PAIROL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-370-9697
Mailing Address - Street 1:737 EAST 10 STREET
Mailing Address - Street 2:737 EAST 10 STREET
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010
Mailing Address - Country:US
Mailing Address - Phone:305-888-7378
Mailing Address - Fax:305-888-7698
Practice Address - Street 1:737 E 10TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3635
Practice Address - Country:US
Practice Address - Phone:305-888-7378
Practice Address - Fax:305-888-7698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207QA0505X, 207Q00000X
FL684891261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1002235823OtherCLIA ID.