Healthcare Provider Details

I. General information

NPI: 1356617351
Provider Name (Legal Business Name): JORGE SUAREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2012
Last Update Date: 02/24/2025
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10305 NW 41ST STREET SUITE 212
DORAL FL
33178
US

IV. Provider business mailing address

5101 SW 8TH ST SUITE 200
CORAL GABLES FL
33134-2442
US

V. Phone/Fax

Practice location:
  • Phone: 786-791-0316
  • Fax: 305-774-5916
Mailing address:
  • Phone: 305-359-5037
  • Fax: 786-509-5544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME143382
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: