Provider Demographics
NPI:1942279625
Name:SILVERSTONE, STEVEN L (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:L
Last Name:SILVERSTONE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6574 BLUE BAY CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7219
Mailing Address - Country:US
Mailing Address - Phone:561-434-1378
Mailing Address - Fax:
Practice Address - Street 1:10300 W FOREST HILL BLVD
Practice Address - Street 2:SUITE 288
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3120
Practice Address - Country:US
Practice Address - Phone:561-792-9110
Practice Address - Fax:561-792-8856
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2884152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20626OtherBLUE CROSS BLUE SHIELD
FL20626XMedicare ID - Type Unspecified