MEDICARE: DR. EDUARDO J HIDALGO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME26139	FL
2	207RH0000X	Hematology (Internal Medicine) Physician	ME0026139	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	78277	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134154834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDUARDO J HIDALGO MD

Provider Business Mailing Address
First Line	:	4006 N OCEAN BLVD
Second Line	:	2ND FLOOR
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-6420
Country	:	US
Telephone Number	:	954-566-4006
Fax Number	:	954-566-1960

Provider Business Practice Location Address
First Line	:	4006 N OCEAN BLVD
Second Line	:	2ND FLOOR
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-6420
Country	:	US
Telephone Number	:	954-566-4006
Fax Number	:	954-566-1960

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/28/2015

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