Healthcare Provider Details

I. General information

NPI: 1033491899
Provider Name (Legal Business Name): KERRY A SILVIA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2011
Last Update Date: 12/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 100166
GAINESVILLE FL
32610-0166
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-6617
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY8353
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: