MEDICARE: ASHLEY SUAREZ

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
1	363A00000X	Physician Assistant
2	363A00000X	Physician Assistant	14059	MN

General Provider Information

NPI Number	:	1841643186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY SUAREZ

Provider Business Mailing Address
First Line	:	9620 LAS VEGAS BLVD S STE E4
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-6508
Country	:	US
Telephone Number	:	702-556-3160
Fax Number	:

Provider Business Practice Location Address
First Line	:	5495 S RAINBOW BLVD STE 202
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1873
Country	:	US
Telephone Number	:	725-726-7914
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2016
Last Update Date	:	04/03/2023

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Directions to “ ASHLEY SUAREZ ” Practice Location

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