Provider Demographics
NPI:1134154834
Name:HIDALGO, EDUARDO J (MD)
Entity type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:J
Last Name:HIDALGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4006 N OCEAN BLVD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-6420
Mailing Address - Country:US
Mailing Address - Phone:954-566-4006
Mailing Address - Fax:954-566-1960
Practice Address - Street 1:4006 N OCEAN BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-6420
Practice Address - Country:US
Practice Address - Phone:954-566-4006
Practice Address - Fax:954-566-1960
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME26139207R00000X
FLME0026139207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL78277OtherBCBS
FLD58428Medicare UPIN
FLGP598AMedicare Oscar/Certification