MR. GARY RICHARD SNELLER II (NPI# 1245229178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245229178 |
| Entity Type | Individual |
| Full Name | MR. GARY RICHARD SNELLER II |
| Credential | PHYSICIAN ASSISTANT |
| Practice Address |
1034 Mar Walt Dr Unit 100 Fort Walton Beach FL 32547-6637 |
| Mailing Address |
1034 Mar Walt Dr Suite 100 Fort Walton Beach FL 32547-6639 |
| Practice Telephone | 8508632153 |
| Practice Fax Number | 8503159350 |
| Mailing Telephone | 8508632153 |
| Mailing Fax Number | 8503159350 |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2020-09-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 008551500 | 05 | |
| BCBS FL | 37804 | 01 |
| Street Address |
1034 MAR WALT DR UNIT 100 |
| City | FORT WALTON BEACH |
| State | FL |
| Zip Code | 32547-6637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063857753 | Brandon Wade Cook | Orthopaedic Surgery | 1034 Mar Walt Dr Unit 100, Fort Walton Beach, FL 32547 | 2013-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255944955 | Theresa Ann Morvay | Behavior Technician | 419 Racetrack Rd Ne, Fort Walton Beach, FL 32547 | 2020-08-24 |
| 1588295422 | Emily Ann Glossop | Nurse Practitioner | 930 Mar Walt Drive C, Fort Walton Beach, FL 32547 | 2020-01-29 |
| 1225669443 | Elizabeth Rogers Nagengast | Physician Assistant | 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 | 2020-01-27 |
| 1497254791 | Carmen Alston | Nurse Practitioner | 930 Mar Walt Dr C, Fort Walton Beach, FL 32547 | 2018-02-02 |
| 1871004960 | Center for Neuropsychological Services Cns | Clinical Neuropsychologist | 1817 Lewis Turner Blvd, Fort Walton Beach, FL 32547 | 2017-10-17 |
| 1194235648 | Robin Wray | Speech-Language Pathologist | 930 Mar Walt Dr D, Fort Walton Beach, FL 32547 | 2017-10-10 |
| 1285007989 | Dynamic Pain & Wellness Pllc | Pain Medicine | 930 Marwalt Drive, Suite B and C, Fort Walton Beach, FL 32547 | 2015-11-04 |
| 1013392810 | Terry Abbott | Social Worker | 648 Overbrook Dr, Fort Walton Beach, FL 32547 | 2015-07-22 |
| 1083024673 | Emily Lohr | Physical Therapy Assistant | 2000 Principle Ln, Ft. Walton Beach, FL 32547 | 2014-05-05 |
| 1831526102 | Laurie Ann Schweppe | Nurse Practitioner | 1005 Mar Walt Drivve, Snf Hospitalist Department, Fort Walton Beach, FL 32547 | 2013-10-02 |
| Find all providers in zip 32547 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316445497 | Rebecca Harris | Physician Assistant | 341 Racetrack Rd Nw Ste C, Fort Walton Beach, FL 32547-1788 | 2018-01-24 |
| 1093135246 | Megan Kayla Renner | Physician Assistant | 1703 Lewis Turner Blvd, Fort Walton Beach, FL 32547-1221 | 2014-04-25 |
| 1134371271 | Kelsie Leeanne Yang | Physician Assistant | 907 Mar Walt Dr, Suite 2024, Fort Walton Beach, FL 32547-6960 | 2008-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598691 | Monica Nancy Ginocchio | Physician Assistant | 1020 Crosspointe Dr Ste 110, Naples, FL 34110-0918 | 2020-11-06 |
| 1427657055 | Alyson Ryall | Physician Assistant | 480 Ventura Pl, Vero Beach, FL 32963-4262 | 2020-10-24 |
| 1104436476 | Forrest Joseph Steslow | Physician Assistant | 1971 Brandywine Rd Apt 305, West Palm Beach, FL 33409-6800 | 2020-08-03 |
| 1063039576 | Joshua Bras Prewitt | Physician Assistant | 4800 Linton Blvd Ste 201, Delray Beach, FL 33445-6584 | 2020-06-30 |
| 1003443904 | Sheila Rhinehart | Physician Assistant | 981 Tarpon Ave, Sebastian, FL 32958-5147 | 2020-03-23 |
| 1952932493 | Lisel Spieler | Physician Assistant | 1173 Fins Up Ct, Daytona Beach, FL 32124-3719 | 2020-02-03 |
| 1326685991 | Nikolai X Lincavage | Physician Assistant | 29277 Us Highway 19 N # 29277, Clearwater, FL 33761-2102 | 2019-12-03 |
| 1356984686 | Zane K Jude | Physician Assistant | 1775 Linton Lake Dr, Delray Beach, FL 33445-6927 | 2019-10-18 |
| 1720635998 | Jose R Munoz | Physician Assistant | 4801 Esedra Ct Apt 203, Lake Worth, FL 33467-5019 | 2019-08-22 |
| 1811559578 | Sydney Gillen | Physician Assistant | 1222 S Orange Ave Fl 2, Orlando, FL 32806-1215 | 2019-07-02 |
| Find all providers with the same taxonomy | ||||
| City | FORT WALTON BEACH |
| Zip Code | 32547 |
Please comment or provide details below to improve the information on MR. GARY RICHARD SNELLER II.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.