Healthcare Provider Details

I. General information

NPI: 1659934222
Provider Name (Legal Business Name): SYNERGY HEALTH CARE AND ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 MARRIOTT DR STE 104
TALLAHASSEE FL
32301-2981
US

IV. Provider business mailing address

124 MARRIOTT DR STE 104
TALLAHASSEE FL
32301-2981
US

V. Phone/Fax

Practice location:
  • Phone: 850-326-2131
  • Fax:
Mailing address:
  • Phone: 850-326-2131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANDREAS R WARD
Title or Position: ASSISTANT CEO
Credential: ARNP
Phone: 850-326-2131