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General NPI Number Information
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NPI Number | 1184090938
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Entity Type | Organization
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Legal Business Name | SYNERGY INTEGRATED HEALTHCARE INC
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Dates
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Enumeration Date | 08/17/2015
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 13020 LIVINGSTON RD
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City | NAPLES
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State | FL
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Zip | 34105-5021
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Country | US
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Telephone | 239-263-3330
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Fax | 239-263-7492
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Provider Business Mailing Address
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Address Line | 13020 LIVINGSTON RD STE 14
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City | NAPLES
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State | FL
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Zip | 34105-5023
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Country | US
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Telephone | 239-263-3330
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Fax | 239-263-7492
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHANIE AHASIC
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Credential | D.C
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Telephone | 239-263-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT27628
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9106306
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME75050
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License Number State |
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