Provider Demographics
NPI:1043291883
Name:SILVERMAN, MICHAEL BRETT (OD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:BRETT
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 CORAL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-5434
Mailing Address - Country:US
Mailing Address - Phone:954-345-5065
Mailing Address - Fax:954-345-5076
Practice Address - Street 1:1380 CORAL RIDGE DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-5434
Practice Address - Country:US
Practice Address - Phone:954-345-5065
Practice Address - Fax:954-345-5076
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOP2254152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT99930Medicare UPIN
FL20457Medicare ID - Type Unspecified