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General NPI Number Information
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NPI Number | 1417809880
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Entity Type | Organization
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Legal Business Name | RENEW PAIN AND WELLNESS CENTER OF SOUTH FLORIDA INC
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Dates
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Enumeration Date | 02/10/2026
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 4614 HOLLYWOOD BLVD
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6502
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Country | US
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Telephone | 954-832-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 4614 HOLLYWOOD BLVD
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6502
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Country | US
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Telephone | 954-832-7100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BEN SHATIL
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Credential | DO, MPH
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Telephone | 954-832-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2081N0008X
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Taxonomy Name | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2084D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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