Provider Demographics
NPI:1487162905
Name:DASILVA, ADLEY (PA)
Entity type:Individual
Prefix:
First Name:ADLEY
Middle Name:
Last Name:DASILVA
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:1941 SE PORT ST LUCIE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5535
Mailing Address - Country:US
Mailing Address - Phone:772-337-1717
Mailing Address - Fax:772-337-1737
Practice Address - Street 1:1941 SE PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5535
Practice Address - Country:US
Practice Address - Phone:772-337-1717
Practice Address - Fax:772-337-1737
Is Sole Proprietor?:No
Enumeration Date:2018-01-18
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9106813363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical