Organization Active NPI

Addictions Behavioral Health Center of America Professional Group, LLC

  • General Practice Physician
  • Oakland Park, FL
National Provider Identifier
1679124879
Registry record updated Sep 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ADDICTIONS BEHAVIORAL HEALTH CENTER OF AMERICA PROFESSIONAL GROUP, LLC
Practice address
1730 E Commercial Blvd
Oakland Park, FL 33334-5721
Phone
(954) 288-2555
NPI assigned
Sep 28, 2019
Last updated
Sep 28, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2019

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

Authorized official

Name
Mark J Korcok
Title
President
Phone
(954) 288-2555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

1730 E Commercial Blvd
Oakland Park, FL 33334-5721

Mailing address

1730 E Commercial Blvd
Oakland Park, FL 33334-5721
Phone (954) 288-2555

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2089835Addictions Behavioral Health Center1730 E Commercial Blvd, Fort Lauderdale, FL 33334Certificate of waiverJan 8, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1569628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569628800000",
    "number": "1679124879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 E COMMERCIAL BLVD",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333345721",
            "telephone_number": "954-288-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 E COMMERCIAL BLVD",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333345721",
            "telephone_number": "954-288-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDICTIONS BEHAVIORAL HEALTH CENTER OF AMERICA PROFESSIONAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-28",
        "last_updated": "2019-09-28",
        "status": "A",
        "authorized_official_last_name": "KORCOK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-288-2555"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.