Provider Demographics
NPI:1003263930
Name:SILVA, SERGIO SR
Entity type:Individual
Prefix:
First Name:SERGIO
Middle Name:
Last Name:SILVA
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 SE 23RD CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33035-1243
Mailing Address - Country:US
Mailing Address - Phone:305-726-6840
Mailing Address - Fax:
Practice Address - Street 1:1990 SE 23RD CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33035-1243
Practice Address - Country:US
Practice Address - Phone:305-726-6840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-18-8479106E00000X
FLBCBA-1-21-53843103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst