Healthcare Provider Details

I. General information

NPI: 1821903154
Provider Name (Legal Business Name): SYNERGY TRIALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 N CONGRESS AVE STE 203
WEST PALM BEACH FL
33407-3221
US

IV. Provider business mailing address

4400 N CONGRESS AVE STE 203
WEST PALM BEACH FL
33407-3221
US

V. Phone/Fax

Practice location:
  • Phone: 516-640-6937
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MOHAMMAD ASIM NISAR
Title or Position: DIRECTOR
Credential:
Phone: 516-640-6937