Provider Demographics
NPI:1932888690
Name:JCW HEALING STATION
Entity type:Organization
Organization Name:JCW HEALING STATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN/CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WILLYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOZANDIER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:954-417-4500
Mailing Address - Street 1:8403 PINES BLVD # 1121
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6609
Mailing Address - Country:US
Mailing Address - Phone:954-417-4500
Mailing Address - Fax:954-417-4501
Practice Address - Street 1:495 NE 157TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33162-5138
Practice Address - Country:US
Practice Address - Phone:786-356-3737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty