Individual
SUSED HIDALGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2010 NW 150TH AVE STE 120, PEMBROKE PINES, FL 33028-2888
(786) 344-1403
Mailing address
5656 W 25TH CT, HIALEAH, FL 33016-4402
(786) 344-1403
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
11007271
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11007271
FL
Other
Enumeration date
07/08/2020
Last updated
12/12/2023
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