Provider Demographics
NPI:1114791936
Name:CONCEPCION, ROXANA (APRN)
Entity Type:Individual
Prefix:
First Name:ROXANA
Middle Name:
Last Name:CONCEPCION
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13800 SW 285TH TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5703
Mailing Address - Country:US
Mailing Address - Phone:786-261-6648
Mailing Address - Fax:
Practice Address - Street 1:13800 SW 285TH TER
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5703
Practice Address - Country:US
Practice Address - Phone:786-261-6648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9433760163WA2000X
FLAPRN11029780363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator