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General NPI Number Information
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NPI Number | 1376646810
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Entity Type | Individual
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Provider Name | HILDA FLORES-VIDAL M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 21300 N. JOHN WAYNE PKWY UNIT 116 BLDG 7
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City | MARICOPA
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State | AZ
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Zip | 85139-8978
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Country | US
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Telephone | 520-423-9699
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Fax | 520-423-9599
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Provider Business Mailing Address
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Address Line | 21300 N JOHN WAYNE PKWY UNIT 116 BLDG 7
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City | MARICOPA
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State | AZ
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Zip | 85139-8978
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Country | US
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Telephone | 520-423-9699
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Fax | 520-423-9599
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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 | 31903
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License Number State | AZ
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