Provider Demographics
NPI: | 1861506529 |
---|---|
Name: | ALIDON, GILDEGARDO P (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | GILDEGARDO |
Middle Name: | P |
Last Name: | ALIDON |
Suffix: | |
Gender: | M |
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: | 1607 SAINT JAMES CT |
Mailing Address - Street 2: | |
Mailing Address - City: | TALLAHASSEE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32308-5352 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 850-878-0191 |
Mailing Address - Fax: | 850-878-8900 |
Practice Address - Street 1: | 1607 SAINT JAMES CT |
Practice Address - Street 2: | |
Practice Address - City: | TALLAHASSEE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32308-5352 |
Practice Address - Country: | US |
Practice Address - Phone: | 850-878-0191 |
Practice Address - Fax: | 850-878-8900 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-08-19 |
Last Update Date: | 2025-09-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | ME0029379 | 2084P0800X, 2084P0802X, 2084P0805X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2084P0802X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Psychiatry |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No | 2084P0805X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Geriatric Psychiatry |