Provider Demographics
NPI:1821055864
Name:SILVA, ELIEZER ROBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIEZER
Middle Name:ROBERTO
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 1:9 ST. SAN FERNANDO
Mailing Address - Street 2:L2
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957-2206
Mailing Address - Country:US
Mailing Address - Phone:787-367-2009
Mailing Address - Fax:
Practice Address - Street 1:J23 AVE BETANCES
Practice Address - Street 2:OFFICE (H) EXTENSION HNOS. DAVILAS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5108
Practice Address - Country:US
Practice Address - Phone:787-777-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13953208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH55732Medicare UPIN
PR0084350Medicare ID - Type UnspecifiedM.D.