Provider Demographics
NPI:1992547079
Name:SYNERGY FAMILY MEDICINE PA
Entity type:Organization
Organization Name:SYNERGY FAMILY MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:L
Authorized Official - Last Name:DILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-441-4304
Mailing Address - Street 1:2955 PINEDA PLAZA WAY STE 105
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7306
Mailing Address - Country:US
Mailing Address - Phone:321-441-4304
Mailing Address - Fax:888-440-2093
Practice Address - Street 1:2955 PINEDA PLAZA WAY STE 105
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7306
Practice Address - Country:US
Practice Address - Phone:321-441-4304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty