Healthcare Provider Details

I. General information

NPI: 1043654817
Provider Name (Legal Business Name): FRED SILVESTRI MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 04/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 S OLD DIXIE HWY SUITE 303
JUPITER FL
33458-7200
US

IV. Provider business mailing address

1004 S OLD DIXIE HWY SUITE 303
JUPITER FL
33458-7200
US

V. Phone/Fax

Practice location:
  • Phone: 561-263-2894
  • Fax: 561-263-3485
Mailing address:
  • Phone: 561-748-2889
  • Fax: 561-748-1523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN BARLOW
Title or Position: PRESIDENT, JUPITER PROFESSIONAL DEV
Credential:
Phone: 561-748-2889