Healthcare Provider Details

I. General information

NPI: 1457895989
Provider Name (Legal Business Name): DR. ELIZABETH SUAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2016
Last Update Date: 12/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8130 EAST CACTUS ROAD SUITE 510
SCOTTSDALE ARIZONA
85260
UM

IV. Provider business mailing address

24218 N 85TH ST
SCOTTSDALE AZ
85255-2878
US

V. Phone/Fax

Practice location:
  • Phone: 480-696-5530
  • Fax:
Mailing address:
  • Phone: 619-699-9392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-16-24919
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: