Healthcare Provider Details

I. General information

NPI: 1437073558
Provider Name (Legal Business Name): CHRISTINA CONCEPCION
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 SW 59TH PL STE 100
SOUTH MIAMI FL
33143-5115
US

IV. Provider business mailing address

7632 SW 93RD PL
MIAMI FL
33173-3382
US

V. Phone/Fax

Practice location:
  • Phone: 305-281-8173
  • Fax:
Mailing address:
  • Phone: 305-281-8173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number11049910
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: