Provider Demographics
NPI:1194784850
Name:SILVA, MIGUEL A (MD)
Entity type:Individual
Prefix:
First Name:MIGUEL
Middle Name:A
Last Name:SILVA
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 1:7848 LAKE UNDERHILL RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8227
Mailing Address - Country:US
Mailing Address - Phone:407-275-2676
Mailing Address - Fax:407-275-2681
Practice Address - Street 1:7848 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8227
Practice Address - Country:US
Practice Address - Phone:407-275-2676
Practice Address - Fax:407-275-2681
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME59432208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL17886OtherBCBS PROVIDER NUMBER
FL17886OtherBCBS PROVIDER NUMBER
17886ZMedicare ID - Type Unspecified