Provider Demographics
NPI:1417569344
Name:SNAPP, BRYAN MARK (RPH)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:MARK
Last Name:SNAPP
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2533 NE 26TH TER
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33305-1612
Mailing Address - Country:US
Mailing Address - Phone:954-235-7125
Mailing Address - Fax:
Practice Address - Street 1:1220 L ST NW STE 900
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-4018
Practice Address - Country:US
Practice Address - Phone:202-962-8839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36852183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist