Silverstardx LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SILVERSTARDX LLC

Practice address

1070 E Brandon Blvd
Brandon, FL 33511-5509

Phone

(813) 579-4888

Fax

(813) 579-4889

NPI assigned

Aug 1, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Maxamillion Phillip Hayden

Title

Ceo

Phone

(813) 579-4888

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1770210700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 E BRANDON BLVD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115509",
            "telephone_number": "813-579-4888",
            "fax_number": "813-579-4889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 E BRANDON BLVD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115509",
            "telephone_number": "813-579-4888",
            "fax_number": "813-579-4889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVERSTARDX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "HAYDEN",
        "authorized_official_first_name": "MAXAMILLION",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-579-4888"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ira L Siegman, M.D.
• Michael G Siegman, MD
• Ali Sigismondi
• Jeannene Silva
• Luis Daniel Silva, MD
• Lauren Simard
• Diana Lee Simeon, O.D.
• Ronald Henry Simeon, O.D.
• Shirley Simeone
• Ayonna Simmons, RBT

• Clinical Medical Laboratory in Brandon, FL
• Providers in Brandon, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.