Provider Demographics
NPI:1598828626
Name:SILVA, MERCEDES (BS PHARM,RPH)
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:SILVA
Suffix:
Gender:F
Credentials:BS PHARM,RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11431 SW 153RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-5210
Mailing Address - Country:US
Mailing Address - Phone:305-323-9865
Mailing Address - Fax:
Practice Address - Street 1:15190 SW 136TH ST
Practice Address - Street 2:SUITE 9
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-2604
Practice Address - Country:US
Practice Address - Phone:305-233-6797
Practice Address - Fax:305-233-6967
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS26423183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist