Provider Demographics
NPI:1255667192
Name:SILVERA, RICARDO D (PA)
Entity Type:Individual
Prefix:MR
First Name:RICARDO
Middle Name:D
Last Name:SILVERA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 SW 62TH AV.
Mailing Address - Street 2:SUITE 535
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4724
Mailing Address - Country:US
Mailing Address - Phone:561-558-8898
Mailing Address - Fax:561-558-8868
Practice Address - Street 1:7000 SW 62ND AVE
Practice Address - Street 2:SUITE 535
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4716
Practice Address - Country:US
Practice Address - Phone:786-268-4044
Practice Address - Fax:786-268-4039
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9106215363A00000X, 363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical