Organization
JCW WELLNESS CLINIC LLC
Active
Other names
JCW WELLNESS CLINIC LLC
Organization subpart
No
Provider details
NPI number
Authorized official
WISLEY CASANOVA MORENO (OWNER)
(786) 695-2202
Entity
Organization
Contact information
Practice address
7392 NW 35TH TER STE 303, MIAMI, FL 33122-1260
(786) 424-8589
Mailing address
7392 NW 35TH TER STE 303, MIAMI, FL 33122-1260
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/30/2024
Last updated
10/01/2024
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