Individual
ALEXANDER FIDALGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CARC #0127
Contact information
Practice address
155 MAPLE ST STE 304, SPRINGFIELD, MA 01105-1828
(813) 409-9590
Mailing address
5 PLANTATION ST APT 1, WORCESTER, MA 01604-4964
(813) 409-9590
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
0127
MA
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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