Provider Demographics
NPI:1508874900
Name:SNIDER, CAROLYN (CRNA)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:SNIDER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 N ROCKY POINT DR E
Mailing Address - Street 2:SUITE 360
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-5810
Mailing Address - Country:US
Mailing Address - Phone:813-289-9613
Mailing Address - Fax:813-418-4144
Practice Address - Street 1:3001 N ROCKY POINT DR E
Practice Address - Street 2:SUITE 360
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5810
Practice Address - Country:US
Practice Address - Phone:813-982-9613
Practice Address - Fax:813-418-4144
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0045770207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100783430AMedicaid
OK100783430AMedicaid