Provider Demographics
NPI:1316281710
Name:JACOB M SILVERSTONE DPM
Entity type:Organization
Organization Name:JACOB M SILVERSTONE DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVERSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-397-8623
Mailing Address - Street 1:12550 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2541
Mailing Address - Country:US
Mailing Address - Phone:305-397-8623
Mailing Address - Fax:305-763-8769
Practice Address - Street 1:12550 BISCAYNE BLVD
Practice Address - Street 2:SUITE 304
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2541
Practice Address - Country:US
Practice Address - Phone:305-835-2797
Practice Address - Fax:305-763-8769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-26
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3464213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty