Provider Demographics
NPI:1639458086
Name:SILVESTRE, CARLOS (BCBA)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:SILVESTRE
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8635 W HILLSBOROUGH AVE # 315
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3810
Mailing Address - Country:US
Mailing Address - Phone:786-353-7149
Mailing Address - Fax:786-605-5161
Practice Address - Street 1:5445 GINGER COVE DR APT E
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-7435
Practice Address - Country:US
Practice Address - Phone:786-353-7149
Practice Address - Fax:786-605-5161
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program