Provider Demographics
NPI:1629742036
Name:SILVERIO, AMANDA MARIE FERNANDES (MD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE FERNANDES
Last Name:SILVERIO
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 1:2140 PASHAK COURT
Mailing Address - Street 2:
Mailing Address - City:MISSISSAUGA
Mailing Address - State:ONTARIO (ON)
Mailing Address - Zip Code:L5A1H7
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2140 PASHAK COURT
Practice Address - Street 2:
Practice Address - City:MISSISSAUGA
Practice Address - State:ONTARIO (ON)
Practice Address - Zip Code:L5A1H7
Practice Address - Country:CA
Practice Address - Phone:647-207-6510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351048500208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000000OtherOHIP