Healthcare Provider Details

I. General information

NPI: 1639191802
Provider Name (Legal Business Name): LOUIS D SNYDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 12/20/2021
Certification Date: 12/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16244 S. MILITARY TRIAL SUITE 560
DELRAY BEACH FL
33484-6534
US

IV. Provider business mailing address

16244 S MILITARY TRL SUITE 560
DELRAY BEACH FL
33484-6534
US

V. Phone/Fax

Practice location:
  • Phone: 561-495-7787
  • Fax: 561-495-1164
Mailing address:
  • Phone: 561-495-7787
  • Fax: 561-495-1164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME0054717
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME0054717
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME0054717
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME0054717
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: