Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003100983 |
---|---|
Provider Name | Lazaro Ulises Suarez |
First Address | Miami, FL 33161-7182 |
Second Address | Doral, FL 33126-1011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2011 |
Last Update Date | 08/06/2011 |