MEDICARE: JUSTINO SILVESTRE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	ME67570	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760463053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTINO SILVESTRE MD

Provider Business Mailing Address
First Line	:	PO BOX 495550
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33949-5550
Country	:	US
Telephone Number	:	941-255-9815
Fax Number	:	941-255-9831

Provider Business Practice Location Address
First Line	:	3524 TAMIAMI TRL
Second Line	:	SUITE D
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-8100
Country	:	US
Telephone Number	:	941-255-9815
Fax Number	:	941-255-9831

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	10/20/2011

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Directions to “ JUSTINO SILVESTRE MD” Practice Location

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