Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 125066163 | IL |
NPI | 1033464847 |
---|---|
Provider Name | Dr. Evadelin Suazo |
First Address | Carolina, PR 00985-2202 |
Second Address | Carolina, PR 00985-2202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2012 |
Last Update Date | 25/06/2015 |