MEDICARE: KENNETH R SNYDER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME0070209	FL

General Provider Information

NPI Number	:	1528177102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH R SNYDER MD

Provider Business Mailing Address
First Line	:	11162 OSPREY LAKE LN
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33412-1115
Country	:	US
Telephone Number	:	561-776-9972
Fax Number	:

Provider Business Practice Location Address
First Line	:	11162 OSPREY LAKE LN
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33412-1115
Country	:	US
Telephone Number	:	561-776-9972
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	07/09/2007

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