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General NPI Number Information
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NPI Number | 1619476785
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Entity Type | Organization
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Legal Business Name | SYNERGY HEALTH GROUP LLC
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Dates
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Enumeration Date | 02/05/2018
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Last Update Date | 02/14/2018
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Provider Practice Location Address
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Address Line | 7828 COLLINS GROVE RD
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7175
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Country | US
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Telephone | 904-721-0894
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Fax | 904-721-9449
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Provider Business Mailing Address
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Address Line | 2735 UNIVERSITY BLVD S
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City | JACKSONVILLE
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State | FL
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Zip | 32216-2548
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Country | US
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Telephone | 904-721-0894
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Fax | 904-721-9449
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. CRYSTAL HALL
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Credential |
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Telephone | 904-721-0894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | ME97437
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number | ME90169
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number | ME97437
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME90169
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License Number State | FL
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