Provider Demographics
NPI:1083892756
Name:SYNERGY REHAB INC.
Entity Type:Organization
Organization Name:SYNERGY REHAB INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOAO
Authorized Official - Middle Name:BALTAZAR
Authorized Official - Last Name:LOPES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-339-7667
Mailing Address - Street 1:160 BAYBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7709
Mailing Address - Country:US
Mailing Address - Phone:561-339-7667
Mailing Address - Fax:561-745-8590
Practice Address - Street 1:160 BAYBERRY CIR
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7709
Practice Address - Country:US
Practice Address - Phone:561-339-7667
Practice Address - Fax:561-745-8590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT10533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty