Healthcare Provider Details

I. General information

NPI: 1255956744
Provider Name (Legal Business Name): SYNERGY HEALTH CARE AND ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 06/10/2020
Certification Date: 06/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 MARRIOTT DR
TALLAHASSEE FL
32301-2995
US

IV. Provider business mailing address

124 MARRIOTT DR
TALLAHASSEE FL
32301-2995
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 Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: SHAUN E LAURIE
Title or Position: CO-OWNER
Credential: MD
Phone: 850-309-1331