Healthcare Provider Details

I. General information

NPI: 1083470470
Provider Name (Legal Business Name): CAMILLE CLAUDETTE HIDALGO APRN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 02/23/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9045 SW 87TH CT
MIAMI FL
33176-2304
US

IV. Provider business mailing address

9045 SW 87TH CT
MIAMI FL
33176-2304
US

V. Phone/Fax

Practice location:
  • Phone: 305-598-7715
  • Fax:
Mailing address:
  • Phone: 305-598-7715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11029438
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: