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NPI Code Detail

MEDICARE: ANGELA CATALINA BOTERO SUAREZ D.D.S

MEDICARE:   ANGELA CATALINA BOTERO SUAREZ  D.D.S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDN27620FL
2122300000XDentist61835CA

General Provider Information

NPI Number : 1609116813
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA CATALINA BOTERO SUAREZ D.D.S
Provider Business Mailing Address
First Line : 5659 BARLETTA DR
Second Line :
City : SAINT CLOUD
State : FL
Zip : 34771-9125
Country : US
Telephone Number : 786-301-6708
Fax Number :
Provider Business Practice Location Address
First Line : 132 MIRROR LAKE DR N
Second Line :
City : SAINT PETERSBURG
State : FL
Zip : 33701-3222
Country : US
Telephone Number : 714-534-3535
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2013
Last Update Date : 03/13/2026

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Directions to “ ANGELA CATALINA BOTERO SUAREZ D.D.S” Practice Location

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