Provider Demographics
NPI:1558438234
Name:JEFFREY P. SNOW M.D., P.A.
Entity Type:Organization
Organization Name:JEFFREY P. SNOW M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTPHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-450-1617
Mailing Address - Street 1:601 N FLAMINGO RD
Mailing Address - Street 2:SUITE 408
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1015
Mailing Address - Country:US
Mailing Address - Phone:954-450-1617
Mailing Address - Fax:954-450-8584
Practice Address - Street 1:601 N FLAMINGO RD
Practice Address - Street 2:SUITE 408
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1015
Practice Address - Country:US
Practice Address - Phone:954-450-1617
Practice Address - Fax:954-450-8584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E22631Medicare UPIN