Basic Information
| Provider Information | |||||||||
| NPI: | 1497922298 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CONCEPCION | ||||||||
| FirstName: | ALBERTO | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CONCEPCION | ||||||||
| OtherFirstName: | ALBERTO | ||||||||
| OtherMiddleName: | R | ||||||||
| OtherNamePrefix: | MR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 2147 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339022147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2394241449 | ||||||||
| FaxNumber: | 2394241421 | ||||||||
| Practice Location | |||||||||
| Address1: | 3501 HEALTH CENTER BLVD | ||||||||
| Address2: | SUITE 2310 | ||||||||
| City: | ESTERO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341358127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2394955020 | ||||||||
| FaxNumber: | 2394955015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2008 | ||||||||
| LastUpdateDate: | 02/14/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | LP02033 | RI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | ME116744 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.