MEDICARE: KENNETH R. SNYDER, MD, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME0070209	FL

General Provider Information

NPI Number	:	1306967005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENNETH R. SNYDER, MD, PA

Provider Business Mailing Address
First Line	:	11162 OSPREY LAKE LN
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33412-1115
Country	:	US
Telephone Number	:	772-321-5070
Fax Number	:

Provider Business Practice Location Address
First Line	:	11162 OSPREY LAKE LN
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33412-1115
Country	:	US
Telephone Number	:	772-321-5070
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	DR. KENNETH RICHARD SNYDER
Credential	:	MD
Telephone Number	:	772-321-5070

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	08/12/2008

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