Provider Demographics
NPI:1447272497
Name:RANDY J SILVERSTINE MD PA
Entity type:Organization
Organization Name:RANDY J SILVERSTINE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SILVERSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-906-7332
Mailing Address - Street 1:1217 EAST AVE SOUTH
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2344
Mailing Address - Country:US
Mailing Address - Phone:941-906-7332
Mailing Address - Fax:941-906-1542
Practice Address - Street 1:1217 EAST AVE SOUTH
Practice Address - Street 2:SUITE 301
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2344
Practice Address - Country:US
Practice Address - Phone:941-906-7332
Practice Address - Fax:941-906-1542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL58360XOtherIND MCR PTAN
FLDG5318OtherRAILROAD MEDICARE
FLDG5318OtherRAILROAD MEDICARE
FLAG047Medicare PIN