Healthcare Provider Details

I. General information

NPI: 1093749111
Provider Name (Legal Business Name): SAMUEL SNYDER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 S SEACREST BLVD
BOYNTON BEACH FL
33435-7969
US

IV. Provider business mailing address

2815 S SEACREST BLVD
BOYNTON BEACH FL
33435-7969
US

V. Phone/Fax

Practice location:
  • Phone: 561-292-4949
  • Fax: 561-292-4612
Mailing address:
  • Phone: 561-292-4949
  • Fax: 561-292-4612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberOS 6909
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: