Provider Demographics
NPI:1295939882
Name:ACON NG, ALICIA (MD)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:ACON NG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 SW 172 AVENUE
Mailing Address - Street 2:SUITE 315
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5592
Mailing Address - Country:US
Mailing Address - Phone:954-507-4604
Mailing Address - Fax:954-507-4606
Practice Address - Street 1:1951 SW 172 AVENUE
Practice Address - Street 2:SUITE 315
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5592
Practice Address - Country:US
Practice Address - Phone:954-507-4604
Practice Address - Fax:954-507-4606
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0015675207V00000X
FLME100481207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
778559777OtherMYUTMB 778559777-COMMERCIAL NUMBER