Provider Demographics
NPI:1881797355
Name:SILVA, FERNANDO L (OD)
Entity type:Individual
Prefix:
First Name:FERNANDO
Middle Name:L
Last Name:SILVA
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 1:3230 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1153
Mailing Address - Country:US
Mailing Address - Phone:305-858-2228
Mailing Address - Fax:305-446-9244
Practice Address - Street 1:3230 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1153
Practice Address - Country:US
Practice Address - Phone:305-858-2228
Practice Address - Fax:305-446-9244
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOP0002309152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL078582200Medicaid
FL0492290001Medicare UPIN
FLD51935Medicare UPIN
FL078582200Medicaid
FL0492290001Medicare NSC