Provider Demographics
NPI:1124469218
Name:SYNAPSE NEUROLOGICAL CARE P.A.
Entity type:Organization
Organization Name:SYNAPSE NEUROLOGICAL CARE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMBANDAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-404-7712
Mailing Address - Street 1:PO BOX 2380
Mailing Address - Street 2:
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34755-2380
Mailing Address - Country:US
Mailing Address - Phone:904-563-4700
Mailing Address - Fax:
Practice Address - Street 1:2753 CITRUS TOWER BLVD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6699
Practice Address - Country:US
Practice Address - Phone:352-404-7712
Practice Address - Fax:352-404-7713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHL761AMedicare UPIN