Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | ME34781 | FL |
NPI | 1003812025 |
---|---|
Provider Name | Dr. Gary Silverman |
First Address | Vero Beach, FL 32960-6574 |
Second Address | Vero Beach, FL 32960-6574 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 10/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D52630 | (02) | FL |