Provider Demographics
NPI:1447234364
Name:SNYDER, JEFFERY S (MD)
Entity Type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:S
Last Name:SNYDER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1121 NW 64TH TER
Mailing Address - Street 2:SUITE B
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4243
Mailing Address - Country:US
Mailing Address - Phone:352-331-3583
Mailing Address - Fax:352-331-3669
Practice Address - Street 1:1121 NW 64TH TER
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4243
Practice Address - Country:US
Practice Address - Phone:352-331-3583
Practice Address - Fax:352-331-3669
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2022-02-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME43158208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273159200Medicaid
FLD85362Medicare UPIN
FL15827XMedicare PIN
FLP00315377Medicare PIN