Provider Demographics
NPI:1215620240
Name:SNELL, CYNTHIA LYNN
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LYNN
Last Name:SNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12610 US HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-1954
Mailing Address - Country:US
Mailing Address - Phone:727-378-0469
Mailing Address - Fax:727-863-7639
Practice Address - Street 1:12610 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-1954
Practice Address - Country:US
Practice Address - Phone:727-378-0469
Practice Address - Fax:727-863-7639
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO4998156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician