Organization
EZEM ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY EZEM APRN (AUTHORIZED OFFICIAL)
(786) 295-1401
Entity
Organization
Contact information
Practice address
4475 SW 179TH WAY, MIRAMAR, FL 33029-6305
(786) 295-1401
Mailing address
4475 SW 179TH WAY, MIRAMAR, FL 33029-6305
(786) 295-1401
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN9169221
LICENSE
FL
Enumeration date
06/22/2020
Last updated
06/22/2020
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