Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 1950 | PR |
N | 204E00000X | Oral & Maxillofacial Surgeon | 12966 | PR |
N | 204E00000X | Oral & Maxillofacial Surgeon | E-3338 | AR |
NPI | 1528107398 |
---|---|
Provider Name | Dr. Jaime Suarez |
First Address | Caguas, PR 00726 |
Second Address | Carolina, PR 00985 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 08/07/2007 |