1235309055 NPI number — DR. KARIM YANERY SUAZO-FLORES M.D.

Table of content: DR. KARIM YANERY SUAZO-FLORES M.D. (NPI 1235309055)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235309055 NPI number — DR. KARIM YANERY SUAZO-FLORES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SUAZO-FLORES
Provider First Name:
KARIM
Provider Middle Name:
YANERY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235309055
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
311 VETERANS BLVD
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
DENHAM SPRINGS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70726-4726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-665-4554
Provider Business Mailing Address Fax Number:
225-665-6995

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
311 VETERANS BLVD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
DENHAM SPRINGS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70726-4726
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-665-4554
Provider Business Practice Location Address Fax Number:
225-665-6995
Provider Enumeration Date:
03/07/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  MD.204161 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1007323 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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