Psynchrony, Inc

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

ME88835 Issued in FL

Legal business name

PSYNCHRONY, INC

Practice address

4700 Sheridan St Ste R
Hollywood, FL 33021-3416

Phone

(954) 983-5330

Fax

(954) 983-5086

NPI assigned

Nov 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Neviana Nenov, M.D., PHD

Title

President

Phone

(954) 983-5330

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114098241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14011 SW 33RD CT",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333304683",
            "telephone_number": "954-382-9690",
            "fax_number": "954-382-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 SHERIDAN ST STE R",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213416",
            "telephone_number": "954-983-5330",
            "fax_number": "954-983-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYNCHRONY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NENOV",
        "authorized_official_first_name": "NEVIANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-983-5330",
        "authorized_official_credential": "M.D., PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "FL",
            "license": "ME88835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.