Provider Demographics
NPI:1265834717
Name:TOTAL WOMEN WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:TOTAL WOMEN WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER / MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:LANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-252-4823
Mailing Address - Street 1:70 NE 167TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33162-3401
Mailing Address - Country:US
Mailing Address - Phone:267-252-4823
Mailing Address - Fax:954-914-7668
Practice Address - Street 1:70 NE 167TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33162-3401
Practice Address - Country:US
Practice Address - Phone:305-705-4575
Practice Address - Fax:954-914-7668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty