Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0400X | Rehabilitation Chiropractor | PT25838 | FL |
Y | 225100000X | Physical Therapist | 25838 | FL |
NPI | 1275843005 |
---|---|
Provider Name | Mr. Nicholas J Concepcion |
First Address | Cutler Bay, FL 33157-7248 |
Second Address | Cutler Bay, FL 33157-7248 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2010 |
Last Update Date | 29/06/2020 |