Healthcare Provider Details

I. General information

NPI: 1376479782
Provider Name (Legal Business Name): KLAY ALAN SNYDER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 CLEVELAND AVE STE 100
FORT MYERS FL
33901-7182
US

IV. Provider business mailing address

3210 CLEVELAND AVE STE 100
FORT MYERS FL
33901-7182
US

V. Phone/Fax

Practice location:
  • Phone: 239-936-6778
  • Fax:
Mailing address:
  • Phone: 239-936-6778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: