JCW Wellness Clinic LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

JCW WELLNESS CLINIC LLC

Practice address

7392 NW 35TH Ter Ste 303
Miami, FL 33122-1260

Phone

(786) 424-8589

NPI assigned

Sep 30, 2024

Last updated

Oct 1, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wisley Casanova Moreno

Title

Owner

Phone

(786) 695-2202

Specialties & licenses 1

Addresses

Other names 1

• JCW WELLNESS CLINIC LLC Former legal business name

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1134947138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7392 NW 35TH TER STE 303",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331221260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7392 NW 35TH TER STE 303",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331221260",
            "telephone_number": "786-424-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JCW WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "CASANOVA MORENO",
        "authorized_official_first_name": "WISLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-695-2202"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JCW WELLNESS CLINIC LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.