Healthcare Provider Details

I. General information

NPI: 1063955649
Provider Name (Legal Business Name): CRYSTAL ANN SILVA M.S.W
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2016
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 S SEMORAN BLVD STE A
ORLANDO FL
32807-1424
US

IV. Provider business mailing address

102 PILLING ST
BROOKLYN NY
11207-1610
US

V. Phone/Fax

Practice location:
  • Phone: 407-704-7811
  • Fax: 407-382-0659
Mailing address:
  • Phone: 718-602-1000
  • Fax: 718-602-1111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: