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General NPI Number Information
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NPI Number | 1477889038
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Entity Type | Organization
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Legal Business Name | OTTO C CONCEPCION,MD.,P.A.
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Dates
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Enumeration Date | 11/02/2009
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Last Update Date | 01/17/2010
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Provider Practice Location Address
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Address Line | 6081 W 24TH AVE APT 106
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City | HIALEAH
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State | FL
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Zip | 33016-6945
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Country | US
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Telephone | 646-641-5513
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Fax |
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Provider Business Mailing Address
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Address Line | 6081 W 24TH AVE APT 106
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City | HIALEAH
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State | FL
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Zip | 33016-6945
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Country | US
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Telephone | 786-230-9980
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | OTTO CESAR CONCEPCION
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Credential | M.D
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Telephone | 786-230-9980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | ME 103235
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License Number State | FL
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