Doctor Name: | DR. BRENDA LIZ CONCEPCION |
NPI Number: | 1164673513 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 17,230 |
Business Practice Address: | 1069 Rr 12 Bayamon, PR - 009569608 |
Business Phone Number: | 7875133667 |
Business Fax Number: | |
Mailing Address: | 1069 Rr 12, BAYAMON |
State: | PR |
Postal Code: | 009569608 |
Phone Number: | 7875133667 |
Fax Number: | |
NPI Enumeration Date: | 10/03/2008 |
NPI Last Update Date: | 07/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 17,230 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |