Healthcare Provider Details

I. General information

NPI: 1780681361
Provider Name (Legal Business Name): VANESSA I SILEBI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 12/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3661 S MIAMI AVE STE 108
MIAMI FL
33133-4206
US

IV. Provider business mailing address

3661 S MIAMI AVE STE 108
MIAMI FL
33133-4206
US

V. Phone/Fax

Practice location:
  • Phone: 305-858-3900
  • Fax: 305-858-9029
Mailing address:
  • Phone: 305-858-3900
  • Fax: 305-858-9029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME88754
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: