Provider Demographics
NPI:1508008764
Name:MARIN POPOWSKI, SILVIA (MD)
Entity Type:Individual
Prefix:
First Name:SILVIA
Middle Name:
Last Name:MARIN POPOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11348 QUAIL ROOST DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6567
Mailing Address - Country:US
Mailing Address - Phone:305-253-1660
Mailing Address - Fax:305-253-5775
Practice Address - Street 1:11348 QUAIL ROOST DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-6567
Practice Address - Country:US
Practice Address - Phone:305-253-1660
Practice Address - Fax:305-253-5775
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA127803207Q00000X
FL147247207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM38181746Medicaid
NM38181746Medicaid