Provider Demographics
NPI:1013359090
Name:SYNERGY CLINICAL GROUP
Entity Type:Organization
Organization Name:SYNERGY CLINICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:MIRICAL
Authorized Official - Middle Name:P
Authorized Official - Last Name:SADDLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-467-4531
Mailing Address - Street 1:1250 LINCOLN RD
Mailing Address - Street 2:#301
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-2267
Mailing Address - Country:US
Mailing Address - Phone:305-467-4531
Mailing Address - Fax:
Practice Address - Street 1:2750 NE 185TH ST
Practice Address - Street 2:SUITE 305
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2876
Practice Address - Country:US
Practice Address - Phone:305-933-5733
Practice Address - Fax:305-933-5233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-19
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health