Healthcare Provider Details

I. General information

NPI: 1265713754
Provider Name (Legal Business Name): CATHERINE SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2011
Last Update Date: 12/20/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5881 TURKEY LAKE RD STE B2-O2
ORLANDO FL
32819-7747
US

IV. Provider business mailing address

5881 TURKEY LAKE RD STE B2-O2
ORLANDO FL
32819-7747
US

V. Phone/Fax

Practice location:
  • Phone: 407-903-1752
  • Fax: 407-903-1757
Mailing address:
  • Phone: 407-903-1752
  • Fax: 407-903-1757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS44770
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: