Provider Demographics
NPI:1053503813
Name:BOBROW-SILVER, MICHELE L
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:L
Last Name:BOBROW-SILVER
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 1:1730 W HILLSBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1531
Mailing Address - Country:US
Mailing Address - Phone:954-574-0755
Mailing Address - Fax:954-574-9198
Practice Address - Street 1:1730 W HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1531
Practice Address - Country:US
Practice Address - Phone:954-574-0755
Practice Address - Fax:954-574-9198
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1560156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0959250001Medicare PIN