Healthcare Provider Details

I. General information

NPI: 1356301394
Provider Name (Legal Business Name): RONALD P SNYDER OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 10/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21126 SAINT ANDREWS BLVD
BOCA RATON FL
33433-2404
US

IV. Provider business mailing address

21126 SAINT ANDREWS BLVD
BOCA RATON FL
33433-2404
US

V. Phone/Fax

Practice location:
  • Phone: 561-347-7977
  • Fax: 561-347-7311
Mailing address:
  • Phone: 561-347-7977
  • Fax: 561-347-7311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC901
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: