Healthcare Provider Details

I. General information

NPI: 1881538858
Provider Name (Legal Business Name): CHANELLE EDALMALY SILVA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 AVE PONCE DE LEON
HATO REY PR
00917-5032
US

IV. Provider business mailing address

715 AVE PONCE DE LEON
HATO REY PR
00917-5032
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2000
  • Fax:
Mailing address:
  • Phone: 787-758-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number17721-I
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: