Individual
DR. CONCEPCION LATOZA AGNILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10475 CENTURION PKWY N, JACKSONVILLE, FL 32256-5003
(904) 450-8090
Mailing address
10475 CENTURION PKWY N, JACKSONVILLE, FL 32256-5003
(904) 450-8090
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME119597
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012348500
—
FL
01
—
14U8K
BCBS
FL
Enumeration date
05/03/2011
Last updated
03/08/2018
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