Individual
DR. IAN A CONCILIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1646 NE 7TH AVE, FORT LAUDERDALE, FL 33305-3028
(772) 618-5527
Mailing address
1646 NE 7TH AVE, FORT LAUDERDALE, FL 33305-3028
(772) 618-5527
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME 78360
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277068700
—
FL
Enumeration date
09/02/2006
Last updated
03/14/2025
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