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General NPI Number Information
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NPI Number | 1164057907
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Entity Type | Organization
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Legal Business Name | SYNERGY WELLNESS CENTERS CORP
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Dates
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Enumeration Date | 03/11/2020
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 17340 NW 27TH AVE
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-4065
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Country | US
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Telephone | 786-255-0613
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Fax |
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Provider Business Mailing Address
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Address Line | 17340 NW 27TH AVE
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-4065
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Country | US
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Telephone | 786-953-6414
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ERICKA P CARDOSO
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Credential | MS
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Telephone | 786-255-0613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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