Provider Demographics
NPI:1063475549
Name:SILBAR, RAYMOND FELLOW (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:FELLOW
Last Name:SILBAR
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 1:10240 SAN JOSE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-6203
Mailing Address - Country:US
Mailing Address - Phone:904-262-9204
Mailing Address - Fax:904-268-9534
Practice Address - Street 1:10240 SAN JOSE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-6203
Practice Address - Country:US
Practice Address - Phone:904-262-9204
Practice Address - Fax:904-268-9534
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53724207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC78788Medicare UPIN
FL07132AMedicare ID - Type Unspecified