Healthcare Provider Details

I. General information

NPI: 1245683630
Provider Name (Legal Business Name): PATRICIA ELIZABETH SILVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2016
Last Update Date: 07/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

L-41 LAUREL SANTA JUANITA
BAYAMON PR
00956
US

IV. Provider business mailing address

430 AGUILA STREET LOS MONTES
DORADO PR
00646
US

V. Phone/Fax

Practice location:
  • Phone: 787-785-6583
  • Fax: 787-785-6583
Mailing address:
  • Phone: 787-413-0645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1051
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: