Provider Demographics
NPI:1487990750
Name:SILVA, WANDA H
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:H
Last Name:SILVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 95TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2140
Mailing Address - Country:US
Mailing Address - Phone:305-993-4400
Mailing Address - Fax:305-993-4402
Practice Address - Street 1:1045 95TH ST STE 100
Practice Address - Street 2:
Practice Address - City:BAY HARBOR ISLANDS
Practice Address - State:FL
Practice Address - Zip Code:33154-2140
Practice Address - Country:US
Practice Address - Phone:305-993-4400
Practice Address - Fax:305-993-4402
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-14
Last Update Date:2014-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9247551363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily