Provider Demographics
NPI:1104146430
Name:SILVERA, JEAN-PIERRE ST PATRICK (DC)
Entity type:Individual
Prefix:DR
First Name:JEAN-PIERRE
Middle Name:ST PATRICK
Last Name:SILVERA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 N HIGHWAY 27
Mailing Address - Street 2:SUITE A
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-2400
Mailing Address - Country:US
Mailing Address - Phone:352-989-5555
Mailing Address - Fax:352-432-2121
Practice Address - Street 1:185 N HIGHWAY 27
Practice Address - Street 2:SUITE A
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2400
Practice Address - Country:US
Practice Address - Phone:352-989-5555
Practice Address - Fax:352-432-2121
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9498111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFX621AMedicare UPIN