Basic Information
Provider Information
NPI: 1952872509
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SILVA PEREZ
FirstName: HECTOR
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 121 S ORANGE AVE STE 940
Address2:  
City: ORLANDO
State: FL
PostalCode: 328013234
CountryCode: US
TelephoneNumber: 4076589687
FaxNumber: 4072864515
Practice Location
Address1: 1834 N ALAFAYA TRL UNIT 3
Address2:  
City: ORLANDO
State: FL
PostalCode: 328264716
CountryCode: US
TelephoneNumber: 4076270062
FaxNumber: 4076747346
Other Information
ProviderEnumerationDate: 12/07/2018
LastUpdateDate: 07/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/10/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X11000420FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

ID Information
IDTypeStateIssuerDescription
MS524497401FLDEAOTHER


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