MEDICARE: JOSE MANUEL SUAREZ MD

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	207RC0000X	Cardiovascular Disease Physician	6519	PR

General Provider Information

NPI Number	:	1922079938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE MANUEL SUAREZ MD

Provider Business Mailing Address
First Line	:	PO BOX 40476
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00940-0476
Country	:	US
Telephone Number	:	787-982-1414
Fax Number	:

Provider Business Practice Location Address
First Line	:	COND SAN JORGE
Second Line	:	SUITE 3A
City	:	SANTURCE
State	:	PR
Zip	:	00912-3359
Country	:	US
Telephone Number	:	787-982-1414
Fax Number	:	787-728-2335

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

Provider Enumeration Date	:	01/28/2006
Last Update Date	:	09/09/2010

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