Organization
CARLOS VIDALON, M.D., P.A.
Active
Parent organization
CARLOS VIDALON, M.D,, P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
CARLOS VIDALON, M.D,, P.A.
Authorized official
DR. CARLOS VIDALON MD (OWNER)
(954) 625-6778
Entity
Organization
Contact information
Practice address
201 NW 82ND AVE, SUITE 504, PLANTATION, FL 33324-7808
(954) 625-6778
(954) 625-6780
Mailing address
201 NW 82ND AVE, SUITE 504, PLANTATION, FL 33324-7808
(954) 625-6778
(954) 625-6780
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
ME0021572
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760480156
NPI
FL
Enumeration date
05/16/2012
Last updated
05/16/2012
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