Provider Demographics
NPI:1386809119
Name:SILAVANO A. HERNANDEZ-HERRERA, M.D., P.A.
Entity type:Organization
Organization Name:SILAVANO A. HERNANDEZ-HERRERA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SILVANO
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:HERNANDEZ-HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-445-5554
Mailing Address - Street 1:35 PONCE DE LEON BLVD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1040
Mailing Address - Country:US
Mailing Address - Phone:305-445-5554
Mailing Address - Fax:305-641-0102
Practice Address - Street 1:35 PONCE DE LEON BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1040
Practice Address - Country:US
Practice Address - Phone:305-445-5554
Practice Address - Fax:305-641-0102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME20718207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD59837Medicare UPIN