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Organization
PEMBROK HEALTH AND WELLNESS CENTER, LLC
Active
Organization
PEMBROK HEALTH AND WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK DEAN KORNHABER DO (MEDICAL DIRECTOR)
(954) 499-4143
Entity
Organization
Contact information
Practice address
12133 PEMBROKE ROAD, PEMBROKE PINES, FL 33025
(954) 499-4143
(954) 499-4146
Mailing address
12133 PEMBROKE ROAD, PEMBROKE PINES, FL 33025
(954) 499-4143
(954) 499-4146
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
FLOS4139
FL
208VP0014X
Interventional Pain Medicine Physician
FLOS4139
FL
Other
Enumeration date
10/22/2010
Last updated
10/22/2010
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