Provider Demographics
NPI:1780859975
Name:SILVESTRI, KAREN A (LMT)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:A
Last Name:SILVESTRI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 500420
Mailing Address - Street 2:
Mailing Address - City:MALABAR
Mailing Address - State:FL
Mailing Address - Zip Code:32950-0420
Mailing Address - Country:US
Mailing Address - Phone:321-722-3344
Mailing Address - Fax:321-722-3344
Practice Address - Street 1:4850 STACK BLVD
Practice Address - Street 2:SUITE F6
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-8544
Practice Address - Country:US
Practice Address - Phone:321-722-3344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0013709225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist