Provider Demographics
NPI:1720006323
Name:SILVA, ENRIQUE MANUEL (MD)
Entity Type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:MANUEL
Last Name:SILVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S PINE ISLAND RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3920
Mailing Address - Country:US
Mailing Address - Phone:904-642-6100
Mailing Address - Fax:904-642-5154
Practice Address - Street 1:4972 TOWN CENTER PKWY STE 301
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-8595
Practice Address - Country:US
Practice Address - Phone:904-642-6100
Practice Address - Fax:904-642-5154
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME44830208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL041956700Medicaid
FL14127OtherBC/BS
FLD52473Medicare UPIN