Healthcare Provider Details

I. General information

NPI: 1821028408
Provider Name (Legal Business Name): DEAN SILVERBERG DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 10/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NORTH FLORIDA/SOUTH GEORGIA VETERANS HEALTH SYSTEM 619 SOUTH MARION AVENUE
LAKE CITY FL
32025
US

IV. Provider business mailing address

NORTH FLORIDA/SOUTH GEORGIA VETERANS HEALTH SYSTEM 619 SOUTH MARION AVENUE
LAKE CITY FL
32025
US

V. Phone/Fax

Practice location:
  • Phone: 386-755-3016
  • Fax: 386-758-6008
Mailing address:
  • Phone: 386-755-3016
  • Fax: 386-758-6008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS5504
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: