| Comprehensive Health & Wellness Center, P.a. | |
|
4040 Sheridan St Hollywood FL 33021-3536 | |
| (954) 322-7166 | |
| (954) 322-7169 |
| Full Name | Comprehensive Health & Wellness Center, P.a. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4040 Sheridan St, Hollywood, Florida |
| Authorized Official Name and Position | Mark Derrick Chin-lenn (PRESIDENT) |
| Authorized Official Contact | 9543227166 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Comprehensive Health & Wellness Center, P.a. 4040 Sheridan St Hollywood FL 33021-3536 Ph: (954) 322-7166 | Comprehensive Health & Wellness Center, P.a. 4040 Sheridan St Hollywood FL 33021-3536 Ph: (954) 322-7166 |
| NPI Number | 1184931339 |
|---|---|
| Provider Enumeration Date | 09/09/2010 |
| Last Update Date | 08/25/2022 |
| Medicare PECOS PAC ID | 0941498562 |
|---|---|
| Medicare Enrollment ID | O20101227000463 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184931339 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME89650 (Florida) | Primary |
| Provider Name | Mark D Chin Lenn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265477509 PECOS PAC ID: 0547262529 Enrollment ID: I20070203000084 |
| Provider Name | Benjamin Lozier Tanner Schlumbrecht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356641989 PECOS PAC ID: 1557772951 Enrollment ID: I20201116000855 |
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