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General NPI Number Information
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NPI Number | 1700291333
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Entity Type | Individual
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Provider Name | RAUL ALEJANDRO ROSARIO-CONCEPCION M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 15955 SW 96TH ST STE 406
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City | MIAMI
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State | FL
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Zip | 33196-1273
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Country | US
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Telephone | 786-596-3876
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Fax | 786-533-9989
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Provider Business Mailing Address
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Address Line | PO BOX 198054
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City | ATLANTA
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State | GA
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Zip | 30384
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Country | UM
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Telephone |
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | ME136095
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 66291
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME136095
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License Number State | FL
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