Provider Demographics
NPI:1639666720
Name:SILVA, IVAN ENRIQUE (PA-C)
Entity Type:Individual
Prefix:
First Name:IVAN
Middle Name:ENRIQUE
Last Name:SILVA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4700 MILLENIA BLVD STE 650
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-6013
Mailing Address - Country:US
Mailing Address - Phone:407-533-6836
Mailing Address - Fax:407-232-9316
Practice Address - Street 1:1201 E BUSINESS HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-8843
Practice Address - Country:US
Practice Address - Phone:956-217-0152
Practice Address - Fax:877-409-3674
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2023-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant