Organization
BEACHES NEUROLOGY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS SNYDER MD (PRESIDENT)
(904) 249-1041
Entity
Organization
Contact information
Practice address
1370 13TH AVE S STE 215, JACKSONVILLE BEACH, FL 32250-3206
(904) 249-1041
(904) 249-9764
Mailing address
PO BOX 17809, JACKSONVILLE, FL 32245-7809
(904) 723-5665
(904) 338-0951
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45912
BCBS
FL
Enumeration date
05/31/2006
Last updated
11/20/2007
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