Provider Demographics
NPI:1629073259
Name:SILVA, NANCY M (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:M
Last Name:SILVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 47957
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33646-0117
Mailing Address - Country:US
Mailing Address - Phone:813-907-8001
Mailing Address - Fax:813-907-5744
Practice Address - Street 1:2527 WINDGUARD CIR
Practice Address - Street 2:SUITE 102
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-7347
Practice Address - Country:US
Practice Address - Phone:813-907-8001
Practice Address - Fax:813-907-5744
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME79058208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259225800Medicaid
FLEI481ZMedicare PIN