Provider Demographics
NPI:1518038355
Name:SILVA, STEPHAN ANTHONY (DPM)
Entity Type:Individual
Prefix:
First Name:STEPHAN
Middle Name:ANTHONY
Last Name:SILVA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7491 N FEDERAL HWY
Mailing Address - Street 2:SUITE C15
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1625
Mailing Address - Country:US
Mailing Address - Phone:561-241-9447
Mailing Address - Fax:561-241-4324
Practice Address - Street 1:7491 N FEDERAL HWY
Practice Address - Street 2:SUITE C15
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1625
Practice Address - Country:US
Practice Address - Phone:561-241-9447
Practice Address - Fax:561-241-4324
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1877213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0787050001Medicare NSC
FL65061Medicare PIN
FLUI0980Medicare UPIN