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NPI Code Detail

MEDICARE: SAMUEL JUSTIN HIDALGO

MEDICARE: SAMUEL JUSTIN HIDALGO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist13302FL

General Provider Information

NPI Number : 1619800539
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL JUSTIN HIDALGO
Provider Business Mailing Address
First Line : 1181 BLUEBIRD AVE
Second Line :
City : MIAMI SPRINGS
State : FL
Zip : 33166-3115
Country : US
Telephone Number : 786-374-1680
Fax Number :
Provider Business Practice Location Address
First Line : 711 E 9TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33010-4553
Country : US
Telephone Number : 786-275-4054
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2026
Last Update Date : 06/08/2026

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Directions to “ SAMUEL JUSTIN HIDALGO ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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