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NPI Code Detail

MEDICARE: SYNERGIE HOLISTIC MEDICINE, INC.

MEDICARE: SYNERGIE HOLISTIC MEDICINE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturistAP 2460FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11992977755OTHERFLNPI INDIVIDUAL

General Provider Information

NPI Number : 1629340682
Entity Type Code : Organization
Provider Name (Legal Business Name) : SYNERGIE HOLISTIC MEDICINE, INC.
Provider Business Mailing Address
First Line : 2141 NW 185TH WAY
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33029-3866
Country : US
Telephone Number : 954-435-4900
Fax Number : 954-435-4922
Provider Business Practice Location Address
First Line : 650 NW 180TH TER
Second Line : SUITE 101
City : PEMBROKE PINES
State : FL
Zip : 33029-2825
Country : US
Telephone Number : 954-435-4900
Fax Number : 954-435-4922
Authorized Official
Title or Position : PRACTITIONER
Name : DR. GISELE ANNE LEON-RITCH
Credential : DOM
Telephone Number : 954-435-4900
Provider Enumeration Date : 02/06/2012
Last Update Date : 02/06/2012

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Directions to “SYNERGIE HOLISTIC MEDICINE, INC. ” Practice Location

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