RENEW PAIN AND WELLNESS CENTER OF SOUTH FLORIDA INC
NPI 1417809880
Pain Medicine - Interventional Pain Medicine in Hollywood, FL
- Organization
- Pain Medicine
- Interventional Pain Medicine
- CLIA Number: 10D2343531
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-06-2028
About RENEW PAIN AND WELLNESS CENTER OF SOUTH FLORIDA INC
This page provides the complete NPI Profile along with additional information for Renew Pain And Wellness Center Of South Florida Inc, a provider established in Hollywood, Florida operating as a Pain Medicine, focusing in interventional pain medicine . The healthcare provider is registered in the NPI registry with number 1417809880 assigned on February 2026. The practitioner's primary taxonomy code is 208VP0014X. The provider is registered as an organization and their NPI record was last updated June 2026. Renew Pain And Wellness Center Of South Florida Inc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Davie Shatil (Authorized Official)
- NPI
- 1417809880 Verify this NPI
- Provider Name
- RENEW PAIN AND WELLNESS CENTER OF SOUTH FLORIDA INC
- Entity Type
- Organization
- Location Address
- 4614 HOLLYWOOD BLVD HOLLYWOOD, FL 33021
- Location Phone
- (954) 256-9422
- Location Fax
- (954) 256-9423
- Mailing Address
- 4614 HOLLYWOOD BLVD HOLLYWOOD, FL 33021
- Mailing Phone
- (954) 256-9422
- Mailing Fax
- (954) 256-9423
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-10-2026
- Last Update Date
- 06-15-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pain Medicine Interventional Pain Medicine
- Taxonomy Code
- 208VP0014X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | |
| 2 | 2081P2900X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | |
| 3 | 261QI0500X | Ambulatory Health Care Facilities | Clinic/Center | |
| 4 | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | |
| 5 | 261QP3300X | Ambulatory Health Care Facilities | Clinic/Center |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D2343531
- Facility Type
- Physician Office
- Certificate Effective Date
- May 07, 2026
- Certificate Expiration Date
- May 06, 2028
- Laboratory Director
- BEN S. SHATIL
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Renew Pain And Wellness Center Of South Florida Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
HOLLYWOOD, FL 33021
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417809880, enumerated as an "organization" on February 10, 2026.
The provider is located at 4614 HOLLYWOOD BLVD HOLLYWOOD, FL 33021 and the phone number is (954) 256-9422.
Pain Medicine with taxonomy code 208VP0014X and a focus in Interventional Pain Medicine.
