Provider Demographics
NPI:1760530513
Name:SILVA, MELISSA DANIELLE (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:DANIELLE
Last Name:SILVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:DANIELLE
Other - Last Name:KIRTLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1845 VETERANS PARK DR STE 260
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0494
Mailing Address - Country:US
Mailing Address - Phone:239-624-0570
Mailing Address - Fax:239-643-8855
Practice Address - Street 1:1845 VETERANS PARK DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0493
Practice Address - Country:US
Practice Address - Phone:239-624-0570
Practice Address - Fax:239-643-8855
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89313208000000X
NC2007-00245208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014527900Medicaid
FL37901OtherBCBS
FL37901ZMedicare ID - Type Unspecified
NC147RYOtherBCBS
NCI04030Medicare UPIN