Healthcare Provider Details

I. General information

NPI: 1093735615
Provider Name (Legal Business Name): MILDRED DONIS SILVA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11616 LAKE UNDERHILL RD SUITE 205
ORLANDO FL
32825-4463
US

IV. Provider business mailing address

6000 TURKEY LAKE RD STE 208
ORLANDO FL
32819-4206
US

V. Phone/Fax

Practice location:
  • Phone: 407-273-7399
  • Fax: 407-273-1928
Mailing address:
  • Phone: 407-648-5252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME0055637
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: