Provider Demographics
NPI:1114194784
Name:HIDALGO, EDUARDO ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:ANTONIO
Last Name:HIDALGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EDUARDO
Other - Middle Name:ANTONIO
Other - Last Name:HIDALGO LOFFREDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:244 N CONGRESS AVE
Mailing Address - Street 2:STE 2A
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-4212
Mailing Address - Country:US
Mailing Address - Phone:561-776-8354
Mailing Address - Fax:561-734-7530
Practice Address - Street 1:244 N CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426
Practice Address - Country:US
Practice Address - Phone:561-734-4535
Practice Address - Fax:561-734-7530
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103493207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine