Healthcare Provider Details

I. General information

NPI: 1891704714
Provider Name (Legal Business Name): JOEL SILBERBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 09/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3001
US

IV. Provider business mailing address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3001
US

V. Phone/Fax

Practice location:
  • Phone: 352-392-3681
  • Fax: 352-846-1455
Mailing address:
  • Phone: 352-392-3681
  • Fax: 352-846-1455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberL4124
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number11788
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number11788
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME59772
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: