Provider Demographics
NPI:1720297369
Name:RODRIGUEZ-HIDALGO, DIANA C (MD)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:C
Last Name:RODRIGUEZ-HIDALGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5955 PONCE DE LEON BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2423
Mailing Address - Country:US
Mailing Address - Phone:305-661-1515
Mailing Address - Fax:305-662-3723
Practice Address - Street 1:5325 GREENWOOD AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2452
Practice Address - Country:US
Practice Address - Phone:305-661-1515
Practice Address - Fax:305-662-3723
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1126412080P0208X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program