Provider Demographics
NPI:1225248214
Name:CONCEPCION, BELKIS (BS)
Entity Type:Individual
Prefix:
First Name:BELKIS
Middle Name:
Last Name:CONCEPCION
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 W 8TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7264
Mailing Address - Country:US
Mailing Address - Phone:786-970-0847
Mailing Address - Fax:305-828-3879
Practice Address - Street 1:4121 W 8TH CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7264
Practice Address - Country:US
Practice Address - Phone:786-970-0847
Practice Address - Fax:305-228-3879
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
FLSI9892355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSI989OtherSPEECH THERAPY ASSISTANT
FL001207800Medicaid