Provider Demographics
NPI:1134633019
Name:FLORENCE EZE PRIMARY CARE CLINIC
Entity type:Organization
Organization Name:FLORENCE EZE PRIMARY CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:T
Authorized Official - Last Name:EZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-718-1777
Mailing Address - Street 1:800 DECATUR ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-3917
Mailing Address - Country:US
Mailing Address - Phone:202-718-1777
Mailing Address - Fax:202-526-6888
Practice Address - Street 1:800 DECATUR ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-3917
Practice Address - Country:US
Practice Address - Phone:202-718-1777
Practice Address - Fax:202-526-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty