Healthcare Provider Details

I. General information

NPI: 1295092351
Provider Name (Legal Business Name): JAMES WILLIAM SNIDER III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5280 LINTON BLVD
DELRAY BEACH FL
33484-6516
US

IV. Provider business mailing address

5280 LINTON BLVD
DELRAY BEACH FL
33484-6516
US

V. Phone/Fax

Practice location:
  • Phone: 561-323-6498
  • Fax: 561-323-6502
Mailing address:
  • Phone: 561-323-6498
  • Fax: 561-323-6502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberD83473
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberME160039
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: