Healthcare Provider Details

I. General information

NPI: 1598408346
Provider Name (Legal Business Name): BRUNO SILVA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12136 COBBLE STONE DR
HUDSON FL
34667-2432
US

IV. Provider business mailing address

21104 WHITE OAK AVE
BOCA RATON FL
33428-1715
US

V. Phone/Fax

Practice location:
  • Phone: 727-863-5474
  • Fax: 727-868-0312
Mailing address:
  • Phone: 561-305-6855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS22595
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: