Provider Demographics
NPI:1497566335
Name:HIDALGO ACUNA, DENNIS DAVID (PBT)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:DAVID
Last Name:HIDALGO ACUNA
Suffix:
Gender:M
Credentials:PBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 SPRING HARBOR CIR APT 2
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-1912
Mailing Address - Country:US
Mailing Address - Phone:352-279-8770
Mailing Address - Fax:507-632-8182
Practice Address - Street 1:2508 SPRING HARBOR CIR APT 2
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-1912
Practice Address - Country:US
Practice Address - Phone:352-279-8770
Practice Address - Fax:507-632-8182
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-20
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4566632147DH246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty