Provider Demographics
NPI:1447342985
Name:SILVA, BRIDGET MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:MARIE
Last Name:SILVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10220 W SAMPLE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-3940
Mailing Address - Country:US
Mailing Address - Phone:954-340-1123
Mailing Address - Fax:954-340-1099
Practice Address - Street 1:10220 W SAMPLE RD STE 1
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-3940
Practice Address - Country:US
Practice Address - Phone:954-340-1123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0062863207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBS3350939Medicare UPIN
FL45218Medicare ID - Type Unspecified