Provider Demographics
NPI:1417550062
Name:DE PADUA SILVA, MARIA (MENTAL HEALTH)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:DE PADUA SILVA
Suffix:
Gender:F
Credentials:MENTAL HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 W CYPRESS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1756
Mailing Address - Country:US
Mailing Address - Phone:954-612-3497
Mailing Address - Fax:
Practice Address - Street 1:5011 WILES RD APT 308
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4203
Practice Address - Country:US
Practice Address - Phone:978-489-4339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH20394101YM0800X
FLMH22649101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty