Provider Demographics
NPI:1750751137
Name:SILVA, REYMUNDO (ARNP)
Entity type:Individual
Prefix:
First Name:REYMUNDO
Middle Name:
Last Name:SILVA
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 W 16TH AVE STE 226U
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4648
Mailing Address - Country:US
Mailing Address - Phone:786-508-3521
Mailing Address - Fax:
Practice Address - Street 1:3750 W 16TH AVE STE 226U
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4648
Practice Address - Country:US
Practice Address - Phone:786-508-3521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-29
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
FL11007600363LP0808X, 363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health