Healthcare Provider Details

I. General information

NPI: 1174782635
Provider Name (Legal Business Name): ERIC A HURTADO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 03/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 CLEVELAND CLINIC BLVD DEPT OF GYN
WESTON FL
33331-3609
US

IV. Provider business mailing address

2950 CLEVELAND CLINIC BLVD DEPT OF GYN
WESTON FL
33331-3609
US

V. Phone/Fax

Practice location:
  • Phone: 954-659-5559
  • Fax: 954-659-5560
Mailing address:
  • Phone: 954-659-5559
  • Fax: 954-659-5560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberME120070
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: