Healthcare Provider Details

I. General information

NPI: 1457540791
Provider Name (Legal Business Name): BENJAMIN SNYDER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2007
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 2ND ST N SUITE 7
SAFETY HARBOR FL
34695-3517
US

IV. Provider business mailing address

801 2ND ST N SUITE 7
SAFETY HARBOR FL
34695-3517
US

V. Phone/Fax

Practice location:
  • Phone: 727-725-8820
  • Fax: 727-725-8361
Mailing address:
  • Phone: 727-725-8820
  • Fax: 727-725-8361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY8848
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: