Healthcare Provider Details

I. General information

NPI: 1194858969
Provider Name (Legal Business Name): SNYDER FAMILY MEDICINE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1042 BELCHER RD S
LARGO FL
33771-3316
US

IV. Provider business mailing address

1042 BELCHER RD S
LARGO FL
33771-3316
US

V. Phone/Fax

Practice location:
  • Phone: 727-531-1050
  • Fax: 727-531-1208
Mailing address:
  • Phone: 727-531-1050
  • Fax: 727-531-1208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHELLE LEE SNYDER
Title or Position: MEDICAL DIRECTOR
Credential: D.O.
Phone: 727-531-1050