Provider Demographics
NPI:1043397722
Name:SNYDER, ROBERT J (DPM)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:SNYDER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 305
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2919
Mailing Address - Country:US
Mailing Address - Phone:954-721-4806
Mailing Address - Fax:954-721-9841
Practice Address - Street 1:7301 N UNIVERSITY DR
Practice Address - Street 2:SUITE 305
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2919
Practice Address - Country:US
Practice Address - Phone:954-721-4806
Practice Address - Fax:954-721-9841
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 908213EP1101X
FLPO908213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT55447Medicare UPIN
FL87565AMedicare ID - Type Unspecified