Healthcare Provider Details

I. General information

NPI: 1255354452
Provider Name (Legal Business Name): JAMES VANCE SNAPP MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13000 BRUCE B DOWNS BLVD. JAMES A HALEY VA HOSPITAL
TAMPA FL
33612
US

IV. Provider business mailing address

1722 MAGDALENE MANOR DR
TAMPA FL
33613-1917
US

V. Phone/Fax

Practice location:
  • Phone: 813-972-2000
  • Fax:
Mailing address:
  • Phone: 813-963-3363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME37896
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: