1245518984 NPI number — PABLO L. SILVA D.D.S. P.A.

Table of content: (NPI 1245518984)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245518984 NPI number — PABLO L. SILVA D.D.S. P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PABLO L. SILVA D.D.S. P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245518984
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1227 DEL PRADO BLVD S
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
CAPE CORAL
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33990-3631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-573-4848
Provider Business Mailing Address Fax Number:
239-573-6040

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1227 DEL PRADO BLVD S
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
CAPE CORAL
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33990-3631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-573-4848
Provider Business Practice Location Address Fax Number:
239-573-6040
Provider Enumeration Date:
07/29/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SILVA
Authorized Official First Name:
PABLO
Authorized Official Middle Name:
LAURENCIO
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
239-573-4848

Provider Taxonomy Codes

  • Taxonomy code: 122300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1811986250 . This is a "PABLO L. SILVA D.D.S." identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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