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General NPI Number Information
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NPI Number | 1457098907
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Entity Type | Individual
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Provider Name | YUNAISY CEBALLO HIDALGO
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Gender | Female
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Dates
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Enumeration Date | 05/17/2022
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 5307 MAIN ST
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-2536
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Country | US
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Telephone | 305-278-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 496 OVERLOOK RD
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City | LOUISVILLE
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State | KY
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Zip | 40229-3385
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Country | US
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Telephone | 502-654-3685
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 1546
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License Number State | FL
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