Provider Demographics
NPI:1366883530
Name:SNYDER, BRADLEY JAMES (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:JAMES
Last Name:SNYDER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 CLEMATIS ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-5312
Mailing Address - Country:US
Mailing Address - Phone:561-805-7135
Mailing Address - Fax:561-805-7138
Practice Address - Street 1:416 CLEMATIS ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-5312
Practice Address - Country:US
Practice Address - Phone:561-805-7135
Practice Address - Fax:561-805-7138
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS50628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist