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General NPI Number Information
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NPI Number | 1891513420
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Entity Type | Organization
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Legal Business Name | PSYNERGY HEALTH MED PLLC
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 4901 VINELAND RD STE 350
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City | ORLANDO
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State | FL
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Zip | 32811-7192
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Country | US
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Telephone | 407-469-5088
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Fax |
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Provider Business Mailing Address
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Address Line | 4901 VINELAND RD STE 350 350
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City | ORLANDO
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State | FL
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Zip | 32811-7192
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Country | US
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Telephone | 407-802-1060
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Fax |
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Authorized Official
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Title or Position | OWNER / AO
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Name | DR. PRADEEP VANGALA
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Credential | MD
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Telephone | 407-469-5088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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