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General NPI Number Information
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NPI Number | 1861142945
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Entity Type | Organization
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Legal Business Name | CONCIERGE MEDICAL ASSOCIATES PLLC
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 475 BILTMORE WAY STE 201
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City | CORAL GABLES
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State | FL
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Zip | 33134-5724
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Country | US
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Telephone | 305-443-5291
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Fax |
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Provider Business Mailing Address
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Address Line | 475 BILTMORE WAY STE 201
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City | CORAL GABLES
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State | FL
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Zip | 33134-5724
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Country | US
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Telephone | 305-443-5291
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | OMAR ISSA
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Credential | MD
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Telephone | 305-443-5291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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