DR. VICDIA L SOSTRE CONCEPCION (NPI# 1205026291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205026291 |
| Entity Type | Individual |
| Full Name | DR. VICDIA L SOSTRE CONCEPCION |
| Credential | MD |
| Practice Address |
5270 Babcock St Ne Ste 1 Palm Bay FL 32905-4616 |
| Mailing Address |
Po Box 1137 Melbourne FL 32902-1137 |
| Practice Telephone | 3217225959 |
| Practice Fax Number | 3217225960 |
| Mailing Telephone | 3219529696 |
| Mailing Fax Number | 3219527937 |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2017-11-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | ACN717 | FL | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 16752 | PR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 016161600 | 05 |
| Street Address |
5270 BABCOCK ST NE STE 1 |
| City | PALM BAY |
| State | FL |
| Zip Code | 32905-4616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649259623 | Doris Margarita Leedy | Pediatrics | 5270 Babcock St Ne Ste 1, Palm Bay, FL 32905-4616 | 2006-01-10 |
| 1851927263 | Michelle Beck | Pharmacist | 5270 Babcock St Ne Ste 1, Palm Bay, FL 32905-4616 | 2020-03-17 |
| 1770128530 | Natalie Swartz | Nurse Practitioner | 5270 Babcock St Ne Ste 1, Palm Bay, FL 32905-4616 | 2019-11-15 |
| 1124660527 | Brevard Health Alliance Inc | Pharmacy | 5270 Babcock St Ne Ste 1, Palm Bay, FL 32905-4616 | 2019-10-17 |
| 1104488337 | Rose Philius | Nurse Practitioner | 5270 Babcock St Ne Ste 1, Palm Bay, FL 32905-4616 | 2019-07-09 |
| 1033592597 | Jessica Regan | Physician Assistant | 5270 Babcock St Ne Ste 1, Palm Bay, FL 32905-4616 | 2015-07-02 |
| 1497183693 | Paulna Thomas | Nurse Practitioner | 5270 Babcock St Ne Ste 1, Palm Bay, FL 32905-4616 | 2013-10-24 |
| 1083953434 | Susana Michelle Vazquez Nieves | Counselor | 5270 Babcock St Ne Ste 1, Palm Bay, FL 32905-4616 | 2013-02-05 |
| 1053450759 | Ramon Isales | Pediatrics | 5270 Babcock St Ne Ste 1, Palm Bay, FL 32905-4616 | 2007-02-06 |
| 1316004815 | Brevard Health Alliance Inc | Clinic/Center | 5270 Babcock St Ne Ste 1, Palm Bay, FL 32905-4616 | 2007-01-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306460928 | Lavell Woodard Jr. | Counselor | 4206 Pinewood Dr Ne, Palm Bay, FL 32905 | 2020-05-29 |
| 1548735699 | Aaron J Milton | Counselor | 1420 Sportsman Lane Ne, Palm Bay, FL 32905 | 2018-10-04 |
| 1871070417 | The Brevard Health Alliance Inc | Clinic/Center | 1361 Florida Ave Ne Ste 2, Palm Bay, FL 32905 | 2018-07-26 |
| 1699266361 | Coastal Visioncare LLC | Optometrist | 2186 Harris Ave Ne Ste 1, Palm Bay, FL 32905 | 2018-05-29 |
| 1184173981 | Jean Elyse Gautreaux | Social Worker | 2475 Palm Bay Rd Ne, Suite 130 #4, Palm Bay, FL 32905 | 2016-09-22 |
| 1174901607 | Reginald Shannon Seecharan | Developmental Therapist | 700 James Cir Ne, Palm Bay, FL 32905 | 2015-05-17 |
| 1881091254 | Courtney Taft | Physical Therapy Assistant | 1155 Malabar Road, Suite 1, Palm Bay, FL 32905 | 2014-12-01 |
| 1548513310 | Juda Marie Decara | Counselor | 4690 Lipscomb St Se, Suite 6c, Palm Bay, FL 32905 | 2012-10-18 |
| 1326308313 | Mohammad Idrees Md, P.a. | Internal Medicine | 1454 Belaire Lane N.e., Palm Bay, FL 32905 | 2012-05-23 |
| 1265704548 | Atm Amin Dds LLC | Dentist | 4620 Lipscomb St Ne, Suite 2, Palm Bay, FL 32905 | 2012-02-02 |
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| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194147611 | Carl Glenmore Morrison Sr. | General Practice | 2125 Windbrook Drive, Palm Bay, FL 32909 | 2014-01-17 |
| 1184799272 | Victor A Arana | General Practice | 1663 Georgia St Ne, Suite 500, Palm Bay, FL 32907-2503 | 2006-11-22 |
| 1558849885 | The Brevard Health Alliance, Inc. | General Practice | 1361 Florida Ave Ne Ste 2, Palm Bay, FL 32905 | 2018-07-30 |
| 1467712695 | Space Coast Volunteers In Medicine | General Practice | 1460 Baytree Dr Ne, Palm Bay, FL 32905-3900 | 2012-05-22 |
| 1790948941 | Sunshine Walk In Clinic | General Practice | 5205 Babcock St Ne, Suite 3, Palm Bay, FL 32905-4638 | 2008-07-08 |
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| 1376140772 | Amy Wrenn | General Practice | 155 Cranes Roost Blvd Ste 2020-a, Altamonte Springs, FL 32701-3468 | 2020-10-08 |
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| 1508463779 | Ashley Zanders Walton | General Practice | 75 Foxfire Ct, Quincy, FL 32351-7293 | 2020-10-01 |
| 1730796830 | Brid M Wade | General Practice | 3199 Cornell Dr, Gulf Breeze, FL 32563-2785 | 2020-09-23 |
| 1902412786 | New Era Medical Pllc | General Practice | 628 Cleveland St Ste A, Clearwater, FL 33755-6603 | 2020-09-17 |
| 1417562414 | Jl Laria Aprn Pa | General Practice | 5751a Sw 40th St, Miami, FL 33155-5301 | 2020-09-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.