Provider Demographics
NPI:1518926807
Name:SNOW, JEFFREY PAUL (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:PAUL
Last Name:SNOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7261 SHERIDAN ST STE 350
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2726
Mailing Address - Country:US
Mailing Address - Phone:954-237-1123
Mailing Address - Fax:954-237-1152
Practice Address - Street 1:7261 SHERIDAN ST STE 350
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2726
Practice Address - Country:US
Practice Address - Phone:954-237-1123
Practice Address - Fax:954-237-1152
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55793208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008833YMedicare ID - Type Unspecified
E22631Medicare UPIN