Provider Demographics
NPI:1205002516
Name:PHYSIMED, P.A.
Entity Type:Organization
Organization Name:PHYSIMED, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:SILVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-325-8525
Mailing Address - Street 1:800 ZEAGLER DR
Mailing Address - Street 2:STE 610
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-3883
Mailing Address - Country:US
Mailing Address - Phone:386-325-8525
Mailing Address - Fax:386-325-8526
Practice Address - Street 1:800 ZEAGLER DR
Practice Address - Street 2:STE 610
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3883
Practice Address - Country:US
Practice Address - Phone:386-325-8525
Practice Address - Fax:386-325-8526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL24080OtherBCBS
FLCG9520OtherRAIL ROAD MEDICARE