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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