Basic Information
| Provider Information | |||||||||
| NPI: | 1710186770 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SILVERSTEIN | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2750 BAHIA VISTA ST | ||||||||
| Address2: | STE 100 | ||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342392640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9419512663 | ||||||||
| FaxNumber: | 9415523312 | ||||||||
| Practice Location | |||||||||
| Address1: | 2750 BAHIA VISTA STREET | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9419512663 | ||||||||
| FaxNumber: | 8135586186 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2007 | ||||||||
| LastUpdateDate: | 08/28/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 125051441 | IL | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | ME109120 | FL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 9548717 | 01 | FL | AETNA | OTHER | 14CF2 | 01 | FL | BCBS | OTHER | 003934000 | 05 | FL | MEDICAID | 344993 | 01 | FL | AVMED | OTHER | 0131437 | 01 | FL | CIGNA | OTHER |