Healthcare Provider Details

I. General information

NPI: 1558035162
Provider Name (Legal Business Name): ALI RACHEL SILVERMAN AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2021
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 S KANNER HWY
STUART FL
34994-4801
US

IV. Provider business mailing address

3801 S KANNER HWY STE 200
STUART FL
34994-4801
US

V. Phone/Fax

Practice location:
  • Phone: 772-223-5945
  • Fax:
Mailing address:
  • Phone: 772-223-2896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY2509
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: