Provider Demographics
NPI:1366449084
Name:SILVERMAN, SANFORD M (MD)
Entity Type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:M
Last Name:SILVERMAN
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 1:100 E SAMPLE RD
Mailing Address - Street 2:STE 200
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-3554
Mailing Address - Country:US
Mailing Address - Phone:954-545-0106
Mailing Address - Fax:954-545-0107
Practice Address - Street 1:100 E SAMPLE RD
Practice Address - Street 2:STE 200
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-3554
Practice Address - Country:US
Practice Address - Phone:954-545-0106
Practice Address - Fax:954-545-0107
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0061410174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF21622Medicare UPIN