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General NPI Number Information
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NPI Number | 1285684753
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Entity Type | Individual
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Provider Name | MANUEL FERNANDEZ-CONCEPCION MD
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Gender | Male
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 1806 N FLAMINGO RD SUITE 440
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1026
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Country | US
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Telephone | 954-620-0025
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Fax | 954-620-0047
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Provider Business Mailing Address
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Address Line | 12600 PEMBROKE RD STE 208
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City | MIRAMAR
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State | FL
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Zip | 33027-2544
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Country | US
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Telephone | 954-620-0026
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Fax | 954-620-0047
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME85860
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME0085860
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License Number State | FL
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