Organization
SYNERGY REVITALIZE MEDICAL CENTER, LLC
Active
Other names
Synergy Revitalize Med & Spa Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELAINE M TAYLOR (PRIMARY CARE PROVIDER)
(301) 602-4658
Entity
Organization
Contact information
Practice address
5457 TWIN KNOLLS RD STE 300-S6, COLUMBIA, MD 21045-3259
(301) 602-4658
(301) 500-3114
Mailing address
5457 TWIN KNOLLS RD STE 300-S11, COLUMBIA, MD 21045-3259
(301) 602-4658
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
2081P0301X
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295045755
NPPES
MA
05
—
598055100
—
MD
Enumeration date
04/29/2022
Last updated
05/15/2026
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