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General NPI Number Information
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NPI Number | 1104072883
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Entity Type | Individual
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Provider Name | CESAR E HIDALGO M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/13/2008
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Last Update Date | 02/25/2010
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Provider Practice Location Address
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Address Line | 333 N BYRON BUTLER PKWY
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City | PERRY
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State | FL
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Zip | 32347-2300
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Country | US
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Telephone | 850-584-0841
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Fax | 850-584-0834
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Provider Business Mailing Address
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Address Line | 1855 HICKORY TRACE DR
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-8389
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Country | US
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Telephone | 904-278-8726
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0060690
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License Number State | FL
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