=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538146675
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EZ HEALTH MEDICAL CENTER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/29/2005
-----------------------------------------------------
Last Update Date | 01/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 737 E 10TH ST
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33010-3635
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-888-7378
-----------------------------------------------------
Fax | 305-888-7698
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 737 EAST 10 STREET 737 EAST 10 STREET
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33010
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-888-7378
-----------------------------------------------------
Fax | 305-888-7698
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | LEONEL DIAZ PAIROL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-370-9697
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207QA0505X
-----------------------------------------------------
Taxonomy Name | Adult Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QR0401X
-----------------------------------------------------
Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
-----------------------------------------------------
License Number | 684891
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------