Carlos Vidalon, M.D., P.a.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

ME0021572 Issued in FL

Legal business name

CARLOS VIDALON, M.D., P.A.

Practice address

201 NW 82ND Ave
Suite 504
Plantation, FL 33324-7808

Phone

(954) 625-6778

Fax

(954) 625-6780

NPI assigned

May 16, 2012

Organization subpart

Yes

Parent organization

CARLOS VIDALON, M.D,, P.A.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Carlos Vidalon, MD

Title

Owner

Phone

(954) 625-6778

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Carlos Vidalon MD PA

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337126400000",
    "number": "1578822185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 NW 82ND AVE",
            "address_2": "SUITE 504",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333247808",
            "telephone_number": "954-625-6778",
            "fax_number": "954-625-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NW 82ND AVE",
            "address_2": "SUITE 504",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333247808",
            "telephone_number": "954-625-6778",
            "fax_number": "954-625-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS VIDALON, M.D., P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARLOS VIDALON, M.D,, P.A.",
        "enumeration_date": "2012-05-16",
        "last_updated": "2012-05-16",
        "status": "A",
        "authorized_official_last_name": "VIDALON",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-625-6778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME0021572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1760480156",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Endocrinology, Diabetes & Metabolism Physician in Plantation, FL
• Providers in Plantation, FL by specialty
• Endocrinology, Diabetes & Metabolism Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.