Provider Demographics
NPI:1679572879
Name:CONCEPCION, GILBERTO G (MD)
Entity Type:Individual
Prefix:
First Name:GILBERTO
Middle Name:G
Last Name:CONCEPCION
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47144207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL061775000Medicaid
FL09520Medicare PIN
09520DMedicare PIN
E89996Medicare UPIN
09520AMedicare PIN