Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME26139 | FL |
Y | 111NI0900X | Internist | ME26139 | FL |
N | 207RH0000X | Hematologist | ME0026139 | FL |
NPI | 1134154834 |
---|---|
Provider Name | Dr. Eduardo J Hidalgo |
First Address | Ft Lauderdale, FL 33308-6420 |
Second Address | Ft Lauderdale, FL 33308-6420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 28/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
78277 | BCBS (01) | FL |
D58428 | (02) | FL |