Basic Information
| Provider Information | |||||||||
| NPI: | 1811470537 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SILVA HECTOR | ||||||||
| FirstName: | ROBERTO | ||||||||
| MiddleName: | JAVIER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4175 W 20TH AVE | ||||||||
| Address2: | |||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330125874 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058250300 | ||||||||
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| Address1: | 4175 W 20TH AVE | ||||||||
| Address2: | |||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330125874 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058250300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2018 | ||||||||
| LastUpdateDate: | 07/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | APRN11019635 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.