=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871534040
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NEAL T SILVERSTEIN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2006
-----------------------------------------------------
Last Update Date | 08/19/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 661 E ALTAMONTE DR SUITE 217
-----------------------------------------------------
City | ALTAMONTE SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32701-5105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-339-3030
-----------------------------------------------------
Fax | 407-339-3003
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 661 E ALTAMONTE DR SUITE 217
-----------------------------------------------------
City | ALTAMONTE SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32701-5105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-339-3030
-----------------------------------------------------
Fax | 407-339-3003
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | ME43697
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------