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General NPI Number Information
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NPI Number | 1770386518
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Entity Type | Organization
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Legal Business Name | JMJ HOLISTIC HEALTH LLC
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Dates
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Enumeration Date | 03/28/2025
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 20348 NW 2ND AVE
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City | MIAMI
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State | FL
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Zip | 33169-2503
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Country | US
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Telephone | 754-364-6154
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 298774
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-8774
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Country | US
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Telephone | 754-364-6154
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Fax |
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Authorized Official
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Title or Position | OWNER OF ENTITY
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Name | MONIQUE MOISE
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Credential |
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Telephone | 754-364-6154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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