Provider Demographics
NPI:1760285969
Name:SYNERGY DIALYSIS OF PEMBROKE PINES, LLC
Entity type:Organization
Organization Name:SYNERGY DIALYSIS OF PEMBROKE PINES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:ANJOS
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-781-7741
Mailing Address - Street 1:50 E SAMPLE RD STE 301
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-3552
Mailing Address - Country:US
Mailing Address - Phone:954-709-9793
Mailing Address - Fax:888-349-8679
Practice Address - Street 1:1897 PRESTON WHITE DR STE 105B
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-5475
Practice Address - Country:US
Practice Address - Phone:954-706-9793
Practice Address - Fax:888-349-8679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment