Provider Demographics
NPI:1346573912
Name:SILVER, RICHARD IAN (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:IAN
Last Name:SILVER
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 1:591 OAK COMMONS BLVD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4202
Mailing Address - Country:US
Mailing Address - Phone:407-943-7100
Mailing Address - Fax:407-943-7328
Practice Address - Street 1:591 OAK COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4202
Practice Address - Country:US
Practice Address - Phone:407-943-7100
Practice Address - Fax:407-943-7328
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219969208800000X, 2088P0231X
FLME149431208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
Provider Identifiers
StateIdentifier IDID TypeIssuer
J400054776Medicare UPIN