Provider Demographics
NPI:1881134682
Name:HIDALGO-DIMAS, ADRIANA (SLP-A)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:HIDALGO-DIMAS
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10750 INSIDE LOOP
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-8880
Mailing Address - Country:US
Mailing Address - Phone:786-343-0871
Mailing Address - Fax:
Practice Address - Street 1:10750 INSIDE LOOP
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-8880
Practice Address - Country:US
Practice Address - Phone:786-343-0871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI2472235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist