Provider Demographics
NPI:1407178247
Name:SCHMID-HIDALGO, FEDERICO JAVIER (DDS)
Entity Type:Individual
Prefix:
First Name:FEDERICO
Middle Name:JAVIER
Last Name:SCHMID-HIDALGO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 BAYVIEW DR STE A
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1710
Mailing Address - Country:US
Mailing Address - Phone:954-563-9722
Mailing Address - Fax:954-563-1912
Practice Address - Street 1:3015 BAYVIEW DR STE A
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1710
Practice Address - Country:US
Practice Address - Phone:954-563-9722
Practice Address - Fax:954-563-1912
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-21
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN189191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice