Healthcare Provider Details

I. General information

NPI: 1558438234
Provider Name (Legal Business Name): JEFFREY P. SNOW M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 02/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N FLAMINGO RD SUITE 408
PEMBROKE PINES FL
33028-1015
US

IV. Provider business mailing address

601 N FLAMINGO RD SUITE 408
PEMBROKE PINES FL
33028-1015
US

V. Phone/Fax

Practice location:
  • Phone: 954-450-1617
  • Fax: 954-450-8584
Mailing address:
  • Phone: 954-450-1617
  • Fax: 954-450-8584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY PAUL SNOW
Title or Position: PRESIDENTPHYSICIAN
Credential: M.D.
Phone: 954-450-1617