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General NPI Number Information
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NPI Number | 1265740815
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Entity Type | Individual
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Provider Name | WANDA SILVA
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Gender | Female
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Dates
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Enumeration Date | 09/16/2010
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Last Update Date | 09/16/2010
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Provider Practice Location Address
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Address Line | 6869 BELFORT OAKS PL
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6242
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Country | US
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Telephone | 904-294-3335
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Fax |
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Provider Business Mailing Address
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Address Line | 3160 HOLLOW TREE CT
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City | JACKSONVILLE
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State | FL
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Zip | 32216-1176
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Country | US
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Telephone | 904-294-3335
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number | MA-44884
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License Number State | FL
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