Healthcare Provider Details

I. General information

NPI: 1053320911
Provider Name (Legal Business Name): JULIO I. SILVA IGNACIO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SAN JOSE # 26
CABO ROJO PR
00623
US

IV. Provider business mailing address

PO BOX 100
CABO ROJO PR
00623-0100
US

V. Phone/Fax

Practice location:
  • Phone: 787-323-4315
  • Fax:
Mailing address:
  • Phone: 787-323-4315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number10135
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: