Concourse Orthotic and Prosthetic Lab

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

CONCOURSE ORTHOTIC AND PROSTHETIC LAB

Practice address

3750 W 16TH Ave
Suite 404
Hialeah, FL 33012-4654

Phone

(305) 362-6962

Fax

(305) 362-4424

NPI assigned

Aug 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Altagracia N Pena, CP

Title

Manager

Phone

(305) 362-6962

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114930765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 W 16TH AVE",
            "address_2": "SUITE 404",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124654",
            "telephone_number": "305-362-6962",
            "fax_number": "305-362-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 W 16TH AVE",
            "address_2": "SUITE 404",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124654",
            "telephone_number": "305-362-6962",
            "fax_number": "305-362-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCOURSE ORTHOTIC AND PROSTHETIC LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "ALTAGRACIA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "305-362-6962",
        "authorized_official_credential": "CP"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orlando Concepcion, APRN
• Otto C Concepcion, M.D.
• Selena Concepcion
• Yaly Concepcion
• Michael Conception, PA
• Diana Beatriz Conde del Pino
• Delia Maria Conde Fernandez
• Janet C Conde
• Karina Conde, RBT
• Wardy Maria Conde, LMHC

• Customized Equipment (DME) in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Customized Equipment (DME) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.