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General NPI Number Information
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NPI Number | 1386350668
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Entity Type | Individual
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Provider Name | MARCO ANTONIO HELIO DA SILVA AP
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Gender | Male
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Dates
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Enumeration Date | 01/30/2023
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 11555 CENTRAL PKWY STE 201
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City | JACKSONVILLE
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State | FL
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Zip | 32224-2693
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Country | US
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Telephone | 904-300-2809
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Fax |
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Provider Business Mailing Address
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Address Line | 64 CARRERA ST APT 64
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32084-3544
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Country | US
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Telephone | 904-496-5220
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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 | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 4422
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 4422
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License Number State | FL
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