Provider Demographics
NPI:1629340682
Name:SYNERGIE HOLISTIC MEDICINE, INC.
Entity Type:Organization
Organization Name:SYNERGIE HOLISTIC MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:GISELE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LEON-RITCH
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:954-435-4900
Mailing Address - Street 1:2141 NW 185TH WAY
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-3866
Mailing Address - Country:US
Mailing Address - Phone:954-435-4900
Mailing Address - Fax:954-435-4922
Practice Address - Street 1:650 NW 180TH TER
Practice Address - Street 2:SUITE 101
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-2825
Practice Address - Country:US
Practice Address - Phone:954-435-4900
Practice Address - Fax:954-435-4922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2460171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1992977755OtherNPI INDIVIDUAL