MEDICARE: CONCEPCION-CIPRIANO AND ASSOCIATES, P.A.

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	101YM0800X	Mental Health Counselor	MH10358	FL
2	103T00000X	Psychologist	PY7798	FL

General Provider Information

NPI Number	:	1528348307
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONCEPCION-CIPRIANO AND ASSOCIATES, P.A.

Provider Business Mailing Address
First Line	:	PO BOX 46876
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33646-0108
Country	:	US
Telephone Number	:	813-728-0016
Fax Number	:

Provider Business Practice Location Address
First Line	:	17407 BRIDGE HILL CT
Second Line	:	SUITE C
City	:	TAMPA
State	:	FL
Zip	:	33647-3522
Country	:	US
Telephone Number	:	813-728-0016
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. YOLANDA CONCEPCION-CIPRIANO
Credential	:	L.M.H.C.
Telephone Number	:	813-728-0016

Provider Enumeration Date	:	08/24/2011
Last Update Date	:	09/15/2011

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