MEDICARE: RENATO CONCEPCION MD PA

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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician

General Provider Information

NPI Number	:	1306960471
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENATO CONCEPCION MD PA

Provider Business Mailing Address
First Line	:	3709 W HAMILTON AVE
Second Line	:	SUITE 9
City	:	TAMPA
State	:	FL
Zip	:	33614-4015
Country	:	US
Telephone Number	:	813-936-7119
Fax Number	:	813-936-2317

Provider Business Practice Location Address
First Line	:	3709 W HAMILTON AVE
Second Line	:	SUITE 9
City	:	TAMPA
State	:	FL
Zip	:	33614-4015
Country	:	US
Telephone Number	:	813-936-7119
Fax Number	:	813-936-2317

Authorized Official
Title or Position	:	VICE-PRES
Name	:	LEILA CONCEPCION
Credential	:
Telephone Number	:	813-936-7119

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	08/22/2020

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