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General NPI Number Information
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NPI Number | 1104608728
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Entity Type | Organization
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Legal Business Name | SYNERGY DIAGNOSTICS INC
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Dates
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Enumeration Date | 10/18/2023
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 611 E ATLANTIC BLVD
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City | POMPANO BEACH
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State | FL
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Zip | 33060-6343
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Country | US
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Telephone | 954-873-0650
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Fax |
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Provider Business Mailing Address
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Address Line | 611 E ATLANTIC BLVD
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City | POMPANO BEACH
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State | FL
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Zip | 33060-6343
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROSS PINE
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Credential | DC
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Telephone | 954-873-0650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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