MJ Doc Health Center 2 Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MJ DOC HEALTH CENTER 2 INC

Doing business as

High Life Healthcenter

Practice address

6101 Hollywood Blvd
Hollywood, FL 33024-7937

Phone

(954) 668-5554

Fax

(813) 433-5481

NPI assigned

Sep 9, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Abdul Rauf, OWNER

Title

Owner

Phone

(954) 668-5554

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HIGH LIFE HEALTHCENTER Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567987200000",
    "number": "1386293785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 DOUGLAS ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330242771",
            "telephone_number": "954-668-5554",
            "fax_number": "813-433-5481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330247937",
            "telephone_number": "954-668-5554",
            "fax_number": "813-433-5481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1341 N Palm Ave",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330263345",
            "country_code": "US",
            "telephone_number": "954-668-5554",
            "fax_number": "813-433-5481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MJ DOC HEALTH CENTER 2 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-09",
        "last_updated": "2019-09-09",
        "status": "A",
        "authorized_official_last_name": "RAUF",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-668-5554",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "ME12885",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HIGH LIFE HEALTHCENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.