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General NPI Number Information
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NPI Number | 1235087362
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Entity Type | Individual
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Provider Name | MS. ANGIE LA CONCHA
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Gender | Female
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 750 E 25TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-3817
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Country | US
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Telephone | 305-694-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 17945 SW 97TH AVE APT 416
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City | PALMETTO BAY
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State | FL
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Zip | 33157-5452
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Country | US
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Telephone | 954-531-7278
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | FL
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