Fla Medical Pain Relief & Detox Center LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

FLA MEDICAL PAIN RELIEF & DETOX CENTER LLC

Practice address

6740 Taft St
Hollywood, FL 33024-3903

Phone

(954) 966-7911

Fax

(954) 966-3352

NPI assigned

Apr 3, 2013

Organization subpart

No

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

Authorized official

Name

Janis Mikus

Title

Director

Phone

(954) 966-7911

Specialties & licenses 3

Addresses

Other names 1

• Florida Medical Health Care Doing business as

Locations

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365638400000",
    "number": "1699018127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6740 TAFT ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330243903",
            "telephone_number": "954-966-7911",
            "fax_number": "954-966-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6740 TAFT ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330243903",
            "telephone_number": "954-966-7911",
            "fax_number": "954-966-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLA MEDICAL PAIN RELIEF & DETOX CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-03",
        "last_updated": "2013-04-11",
        "status": "A",
        "authorized_official_last_name": "MIKUS",
        "authorized_official_first_name": "JANIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "954-966-7911"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Medical Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.