Provider Demographics
NPI:1619222130
Name:GILBERTO CONCEPCION MD PA
Entity Type:Organization
Organization Name:GILBERTO CONCEPCION MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GILBERTO
Authorized Official - Middle Name:G
Authorized Official - Last Name:CONCEPCION
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-702-9393
Mailing Address - Street 1:PO BOX 430852
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33243-0852
Mailing Address - Country:US
Mailing Address - Phone:305-702-9393
Mailing Address - Fax:877-221-8306
Practice Address - Street 1:6140 SW 70TH ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3419
Practice Address - Country:US
Practice Address - Phone:305-702-9393
Practice Address - Fax:877-221-8306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-20
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47144207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty