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General NPI Number Information
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NPI Number | 1629340682
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Entity Type | Organization
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Legal Business Name | SYNERGIE HOLISTIC MEDICINE, INC.
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Dates
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Enumeration Date | 02/06/2012
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Last Update Date | 02/06/2012
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Provider Practice Location Address
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Address Line | 650 NW 180TH TER SUITE 101
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-2825
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Country | US
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Telephone | 954-435-4900
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Fax | 954-435-4922
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Provider Business Mailing Address
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Address Line | 2141 NW 185TH WAY
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-3866
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Country | US
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Telephone | 954-435-4900
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Fax | 954-435-4922
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Authorized Official
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Title or Position | PRACTITIONER
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Name | DR. GISELE ANNE LEON-RITCH
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Credential | DOM
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Telephone | 954-435-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP 2460
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License Number State | FL
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