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General NPI Number Information
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NPI Number | 1790511442
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Entity Type | Organization
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Legal Business Name | EZ HEALTH MEDICAL GROUP PA
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Dates
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Enumeration Date | 09/10/2024
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1910 S STAPLEY DR STE 120
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City | MESA
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State | AZ
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Zip | 85204-6676
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Country | US
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Telephone | 385-327-2541
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Fax | 239-232-2567
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Provider Business Mailing Address
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Address Line | 1801 NE 123RD ST STE 314
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2883
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Country | US
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Telephone | 385-327-2541
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Fax | 239-232-2567
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | NIKHIL JHUNJHNUWALA
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Credential |
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Telephone | 385-327-2541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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