Healthcare Provider Details

I. General information

NPI: 1588450100
Provider Name (Legal Business Name): SYOAK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3470 NW 82ND AVE STE 630
DORAL FL
33122-1178
US

IV. Provider business mailing address

3470 NW 82ND AVE STE 630
DORAL FL
33122-1178
US

V. Phone/Fax

Practice location:
  • Phone: 305-845-8832
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIE REGALADO
Title or Position: AUTHORIZED REPRESENTATIVE
Credential:
Phone: 305-845-8832