Provider Demographics
NPI:1043488539
Name:SNYDERMAN, HETTY ZOE (DO)
Entity Type:Individual
Prefix:DR
First Name:HETTY
Middle Name:ZOE
Last Name:SNYDERMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:HETTY
Other - Middle Name:ZOE
Other - Last Name:WEINSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:21 CARROTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-7531
Mailing Address - Country:US
Mailing Address - Phone:239-898-8988
Mailing Address - Fax:
Practice Address - Street 1:21 CARROTWOOD CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-7531
Practice Address - Country:US
Practice Address - Phone:239-898-8988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0005121208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF07552Medicare UPIN