Provider Demographics
NPI:1316403447
Name:HIDALGO, MIRAIDYS DE LA CARIDAD
Entity Type:Individual
Prefix:
First Name:MIRAIDYS
Middle Name:DE LA CARIDAD
Last Name:HIDALGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6781 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3936
Mailing Address - Country:US
Mailing Address - Phone:786-355-5987
Mailing Address - Fax:
Practice Address - Street 1:6781 SCOTT ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-3936
Practice Address - Country:US
Practice Address - Phone:786-355-5987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician