Provider Demographics
NPI:1740078146
Name:SILVA, YAIRA ENID (LMT)
Entity type:Individual
Prefix:
First Name:YAIRA
Middle Name:ENID
Last Name:SILVA
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4034 PEBBLE BROOKE CIR
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-8204
Mailing Address - Country:US
Mailing Address - Phone:904-477-0681
Mailing Address - Fax:
Practice Address - Street 1:4034 PEBBLE BROOKE CIR
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-8204
Practice Address - Country:US
Practice Address - Phone:904-477-0681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA39602225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist