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NPI Code Detail

MEDICARE: MS. ANGIE LA CONCHA

MEDICARE: MS. ANGIE LA CONCHA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramFL

General Provider Information

NPI Number : 1235087362
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANGIE LA CONCHA
Provider Business Mailing Address
First Line : 17945 SW 97TH AVE APT 416
Second Line :
City : PALMETTO BAY
State : FL
Zip : 33157-5452
Country : US
Telephone Number : 954-531-7278
Fax Number :
Provider Business Practice Location Address
First Line : 750 E 25TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33013-3817
Country : US
Telephone Number : 305-694-5400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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Directions to “ MS. ANGIE LA CONCHA ” Practice Location

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