Individual
IVAN ERNESTO KIDD BARALT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
145 SW 8TH ST UNIT 2101, MIAMI, FL 33130-3664
(305) 322-7894
(305) 322-7894
Mailing address
145 SW 8TH ST UNIT 2101, MIAMI, FL 33130-3664
(305) 322-7894
(305) 322-7894
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
20-190
FL
363A00000X
Physician Assistant
2832-P.A.
PR
Other
Enumeration date
10/14/2025
Last updated
10/24/2025
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