Provider Demographics
NPI:1134640089
Name:SYNERGIC HEALTHCARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:SYNERGIC HEALTHCARE SOLUTIONS LLC
Other - Org Name:FAST TRACK URGENT CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARON
Authorized Official - Middle Name:G
Authorized Official - Last Name:DIECIDUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-925-1903
Mailing Address - Street 1:3301 W GANDY BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-2931
Mailing Address - Country:US
Mailing Address - Phone:813-925-1903
Mailing Address - Fax:813-749-8370
Practice Address - Street 1:1 TAMPA GENERAL CIR
Practice Address - Street 2:
Practice Address - City:DAVIS ISLAND
Practice Address - State:FL
Practice Address - Zip Code:33606-3571
Practice Address - Country:US
Practice Address - Phone:813-925-1903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-30
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site