Provider Demographics
NPI:1366497588
Name:SILVA, RICHARD C (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:C
Last Name:SILVA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E SAMPLE RD STE 230
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-3550
Mailing Address - Country:US
Mailing Address - Phone:954-943-9670
Mailing Address - Fax:954-943-9671
Practice Address - Street 1:150 E SAMPLE RD STE 230
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-3550
Practice Address - Country:US
Practice Address - Phone:954-943-9670
Practice Address - Fax:954-943-9671
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7728207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS7728OtherLICENSE
FLOS7728OtherLICENSE