1356617351 NPI number — DR. JORGE SUAREZ MD

Table of content: DR. JORGE SUAREZ MD (NPI 1356617351)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356617351 NPI number — DR. JORGE SUAREZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SUAREZ
Provider First Name:
JORGE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1356617351
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5101 SW 8TH ST
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
CORAL GABLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33134-2442
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-359-5037
Provider Business Mailing Address Fax Number:
786-509-5544

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10305 NW 41ST STREET
Provider Second Line Business Practice Location Address:
SUITE 212
Provider Business Practice Location Address City Name:
DORAL
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33178
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-791-0316
Provider Business Practice Location Address Fax Number:
305-774-5916
Provider Enumeration Date:
03/24/2012

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: 207RG0100X , with the licence number:  ME143382 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 105848600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com