Provider Demographics
NPI:1437687894
Name:EZE, FLORENCE TITILOLA (NP)
Entity type:Individual
Prefix:
First Name:FLORENCE
Middle Name:TITILOLA
Last Name:EZE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3904 DEEP HOLLOW WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1287
Mailing Address - Country:US
Mailing Address - Phone:240-245-4164
Mailing Address - Fax:
Practice Address - Street 1:807 E BALTIMORE ST UNIT 1-R
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-4706
Practice Address - Country:US
Practice Address - Phone:240-245-4164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1031167364SG0600X
MDR207637363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology