Provider Demographics
NPI:1235113515
Name:SILVERA, ROBERT R (MD,)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:R
Last Name:SILVERA
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 1:800 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:385-325-8526
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:385-325-8526
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00583372081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064382300Medicaid
FL064382300Medicaid