Provider Demographics
NPI:1154716033
Name:SNYDER, SCOTT (LMT)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:SNYDER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 CLEARWATER PARK RD
Mailing Address - Street 2:#1102
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-6226
Mailing Address - Country:US
Mailing Address - Phone:561-291-1542
Mailing Address - Fax:
Practice Address - Street 1:616 CLEARWATER PARK RD
Practice Address - Street 2:#1102
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-6226
Practice Address - Country:US
Practice Address - Phone:561-291-1542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA75420225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist