Provider Demographics
NPI:1396971966
Name:HIDAY, NEDRA L (AP)
Entity type:Individual
Prefix:
First Name:NEDRA
Middle Name:L
Last Name:HIDAY
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 880615
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33488-0615
Mailing Address - Country:US
Mailing Address - Phone:561-852-8081
Mailing Address - Fax:561-852-3522
Practice Address - Street 1:21301 POWERLINE RD
Practice Address - Street 2:GROVE CENTER #215
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2388
Practice Address - Country:US
Practice Address - Phone:561-852-8081
Practice Address - Fax:561-852-3522
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP0000561171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist