MEDICARE: SYNERGY OF MINDS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency
3	252Y00000X	Early Intervention Provider Agency
4	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
5	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1497226153
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYNERGY OF MINDS INC.

Provider Business Mailing Address
First Line	:	320 N RIDGEWOOD DR
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33870-7205
Country	:	US
Telephone Number	:	863-576-9091
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 N RIDGEWOOD DR
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33870-7205
Country	:	US
Telephone Number	:	305-851-1732
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LOURDES TRIANA
Credential	:
Telephone Number	:	863-576-9091

Provider Enumeration Date	:	12/06/2018
Last Update Date	:	12/01/2020

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