Provider Demographics
NPI:1558924894
Name:MEDIZEN HEALTHCARE
Entity Type:Organization
Organization Name:MEDIZEN HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LIEU-CHI
Authorized Official - Last Name:HARKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-869-7555
Mailing Address - Street 1:2611 BAYSHORE BLVD APT 802
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-7362
Mailing Address - Country:US
Mailing Address - Phone:310-869-7555
Mailing Address - Fax:
Practice Address - Street 1:2611 BAYSHORE BLVD APT 802
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-7362
Practice Address - Country:US
Practice Address - Phone:310-869-7555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-22
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service