Provider Demographics
NPI:1740576735
Name:HUGO, SID (DO)
Entity Type:Individual
Prefix:DR
First Name:SID
Middle Name:
Last Name:HUGO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 GRANT AVE W
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-4101
Mailing Address - Country:US
Mailing Address - Phone:949-413-2821
Mailing Address - Fax:
Practice Address - Street 1:6300 NW 60TH WAY
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067-4422
Practice Address - Country:US
Practice Address - Phone:949-413-2821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13092207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014882000Medicaid
FLII227ZMedicare PIN