Healthcare Provider Details

I. General information

NPI: 1295410173
Provider Name (Legal Business Name): LIEN CRUZ SUAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2023
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10825 SW 184TH ST
CUTLER BAY FL
33157-6736
US

IV. Provider business mailing address

15340 SW 106TH TER APT 814
MIAMI FL
33196-2757
US

V. Phone/Fax

Practice location:
  • Phone: 305-253-3613
  • Fax:
Mailing address:
  • Phone: 786-326-9611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-272961
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: