Healthcare Provider Details

I. General information

NPI: 1093636896
Provider Name (Legal Business Name): MATTHEW SUAREZ DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 LUXEMBURG CT APT 104
LAKE WORTH FL
33467-5152
US

IV. Provider business mailing address

4545 LUXEMBURG CT APT 104
LAKE WORTH FL
33467-5152
US

V. Phone/Fax

Practice location:
  • Phone: 561-801-4541
  • Fax: 561-801-4541
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT45179
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: