Provider Demographics
NPI:1073669214
Name:SILVER, IRVING LIONEL (MA)
Entity Type:Individual
Prefix:MR
First Name:IRVING
Middle Name:LIONEL
Last Name:SILVER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8916 ANGELICA DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-5445
Mailing Address - Country:US
Mailing Address - Phone:407-754-6069
Mailing Address - Fax:407-909-0465
Practice Address - Street 1:7353 W SAND LAKE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5258
Practice Address - Country:US
Practice Address - Phone:407-754-6069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2073106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist