Provider Demographics
NPI:1821722836
Name:SYNERGIC HEALTHCARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:SYNERGIC HEALTHCARE SOLUTIONS LLC
Other - Org Name:TGH URGENT CARE POWERED BY FAST TRACK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
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:
Practice Address - Street 1:4949 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-3800
Practice Address - Country:US
Practice Address - Phone:813-925-1903
Practice Address - Fax:813-749-8370
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SYNERGIC HEALTHCARE SOLUTIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care