Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Renew Pain and Wellness Center of South Florida Inc

Organization Psychologist · NPI 1417809880

Renew Pain and Wellness Center of South Florida Inc is a Psychologist in Hollywood, Florida. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
9
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4614 Hollywood Blvd
Hollywood, FL 33021-6502
Phone: (954) 256-9422
Fax: (954) 256-9423
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Interventional Pain Medicine Physician (primary) Taxonomy 208VP0014X
Psychologist Taxonomy 103T00000X
Pain Medicine (Anesthesiology) Physician Taxonomy 207LP2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081P2900X
Psychiatry Physician Taxonomy 2084P0800X
Infusion Therapy Clinic/Center Taxonomy 261QI0500X
Mental Health Clinic/Center (Including Community Mental Health Center) Taxonomy 261QM0801X
Pain Clinic/Center Taxonomy 261QP3300X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1417809880
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Davie Shatil — Practice Manager · (954) 256-9422
Other names Renew Pain And Wellness Center Of South Florida
NPI enumeratedFebruary 10, 2026
Last updated in NPPESJuly 27, 2026
Certification dateJuly 27, 2026
Mailing address4614 Hollywood Blvd, Hollywood, FL 33021-6502

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