Provider Demographics
NPI:1447321450
Name:SILVA, JORGE E (MD,)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:E
Last Name:SILVA
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 PASEO REAL MONTEJO
Mailing Address - Street 2:HERMANAS MENA
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-5711
Mailing Address - Country:US
Mailing Address - Phone:787-884-3224
Mailing Address - Fax:
Practice Address - Street 1:112 MEDICAL OFFICE
Practice Address - Street 2:HERNANDEZ CARRION , URB. ATENAS
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12771207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY35562OtherSTATE LICENSE
PR12771OtherSTATE LICENSE
KY35562OtherSTATE LICENSE