Provider Demographics
NPI:1821371931
Name:SNYDER, KATHY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20741 BRUCE B DOWNS BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2913
Mailing Address - Country:US
Mailing Address - Phone:813-907-0878
Mailing Address - Fax:
Practice Address - Street 1:20741 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2913
Practice Address - Country:US
Practice Address - Phone:813-907-0878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-25
Last Update Date:2014-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39042183500000X
VA0202011130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist