Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | ME 47423 | FL |
NPI | 1013931427 |
---|---|
Provider Name | Manuel Suarez |
First Address | Pembroke Pines, FL 33024-7355 |
Second Address | Hialeah, FL 33012-3197 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D64964 | (02) | FL |