Provider Demographics
NPI:1376158246
Name:HIDALGO, HILESCA T (APRN)
Entity Type:Individual
Prefix:
First Name:HILESCA
Middle Name:T
Last Name:HIDALGO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6536 STADIUM DR STE G
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7575
Mailing Address - Country:US
Mailing Address - Phone:813-501-5445
Mailing Address - Fax:447-200-2033
Practice Address - Street 1:6536 STADIUM DR STE G
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-7575
Practice Address - Country:US
Practice Address - Phone:813-501-5445
Practice Address - Fax:447-200-2033
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11009035207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty