Organization
MJ DOC HEALTH CENTER 2 INC
Active
Other names
HIGH LIFE HEALTHCENTER
Organization subpart
No
Provider details
NPI number
Authorized official
ABDUL RAUF OWNER (OWNER)
(954) 668-5554
Entity
Organization
Contact information
Practice address
6101 HOLLYWOOD BLVD, HOLLYWOOD, FL 33024-7937
(954) 668-5554
(813) 433-5481
Mailing address
7400 DOUGLAS ST, HOLLYWOOD, FL 33024-2771
(954) 668-5554
(813) 433-5481
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME12885
MEDICAL LICENSE NUMBER
FL
Enumeration date
09/09/2019
Last updated
09/09/2019
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