Provider Demographics
NPI:1427294651
Name:DESILVA, CYRIL CHITTA (MD)
Entity type:Individual
Prefix:
First Name:CYRIL
Middle Name:CHITTA
Last Name:DESILVA
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:PO BOX 11407
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-1431
Mailing Address - Country:US
Mailing Address - Phone:850-770-3030
Mailing Address - Fax:850-770-3035
Practice Address - Street 1:801 E 6TH ST STE 302
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401
Practice Address - Country:US
Practice Address - Phone:850-770-3030
Practice Address - Fax:850-770-3035
Is Sole Proprietor?:No
Enumeration Date:2008-12-17
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME103399207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000525200Medicaid