Organization Active NPI

Comprehensive Health & Wellness Center, P.a.

  • Primary Care Clinic/Center
  • Hollywood, FL
National Provider Identifier
1184931339
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
ME89650 Issued in FL
Legal business name
COMPREHENSIVE HEALTH & WELLNESS CENTER, P.A.
Practice address
4040 Sheridan St
Hollywood, FL 33021-3536
Phone
(954) 322-7166
Fax
(954) 322-7169
NPI assigned
Sep 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mark Derrick Chin-Lenn, M.D.NPI 1265477509
Title
President
Phone
(954) 322-7166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X ME89650 FL Primary

Addresses

Primary practice location

4040 Sheridan St
Hollywood, FL 33021-3536

Mailing address

4040 Sheridan St
Hollywood, FL 33021-3536
Phone (954) 322-7166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101227000463 FL Part B Supplier - Clinic/Group Practice 0941498562 Receives reassigned benefits from 5 practitioners
Practice locations: Hollywood, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2016186Comprehensive Health and Wellness Center PA4040 Sheridan St, Hollywood, FL 33021Certificate of waiverNov 14, 2026

National Provider Directory

National Provider Directory

Locations

4040 Sheridan St
Hollywood, FL 33021
Phone (954) 322-7166

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661385600000",
    "number": "1184931339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213536",
            "telephone_number": "954-322-7166",
            "fax_number": "954-322-7169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213536",
            "telephone_number": "954-322-7166",
            "fax_number": "954-322-7169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE HEALTH & WELLNESS CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-09",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A",
        "authorized_official_last_name": "CHIN-LENN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DERRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-322-7166",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME89650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.