Provider Demographics
NPI:1306907027
Name:SILVIO C. TRAVALIA, M.D., P.A.
Entity type:Organization
Organization Name:SILVIO C. TRAVALIA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-434-9222
Mailing Address - Street 1:694 8TH ST N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5523
Mailing Address - Country:US
Mailing Address - Phone:239-434-9222
Mailing Address - Fax:239-434-9648
Practice Address - Street 1:694 8TH ST N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5523
Practice Address - Country:US
Practice Address - Phone:239-434-9222
Practice Address - Fax:239-434-9648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0024913207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD85494Medicare UPIN
FL29942Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID#