Provider Demographics
NPI:1205400959
Name:EZ HEALTHCARE ASSOCIATES INC.
Entity Type:Organization
Organization Name:EZ HEALTHCARE ASSOCIATES INC.
Other - Org Name:LIVE MEDSPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-699-9791
Mailing Address - Street 1:8205 NW 12TH ST UNIT 4
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1837
Mailing Address - Country:US
Mailing Address - Phone:305-699-9791
Mailing Address - Fax:786-946-1156
Practice Address - Street 1:8205 NW 12TH ST UNIT 4
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1837
Practice Address - Country:US
Practice Address - Phone:305-699-9791
Practice Address - Fax:786-946-1156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-18
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty