Healthcare Provider Details

I. General information

NPI: 1730975285
Provider Name (Legal Business Name): EZ HEALTH PRIMARY AND BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 E BALTIMORE ST UNIT 1-R
BALTIMORE MD
21202-4706
US

IV. Provider business mailing address

3904 DEEP HOLLOW WAY
BOWIE MD
20721-1287
US

V. Phone/Fax

Practice location:
  • Phone: 240-245-4164
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: FLORENCE T EZE
Title or Position: OWNER
Credential:
Phone: 240-245-4164