Provider Demographics
NPI:1144530072
Name:HIDALGO, LUCY
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:
Last Name:HIDALGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2138 N.E 123 STREET
Mailing Address - Street 2:ESENCIA DAY SPA
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181
Mailing Address - Country:US
Mailing Address - Phone:786-489-9715
Mailing Address - Fax:954-964-7864
Practice Address - Street 1:2138 N.E 123 STREET
Practice Address - Street 2:ESENCIA DAY SPA
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181
Practice Address - Country:US
Practice Address - Phone:786-489-9715
Practice Address - Fax:954-964-7864
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist