Healthcare Provider Details

I. General information

NPI: 1497770838
Provider Name (Legal Business Name): MIGUEL ANGEL SUAREZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NW 16TH ST DEPARTMENT OF PATHOLOGY (MIAMI VA MEDICAL CENTER)
MIAMI FL
33125-1624
US

IV. Provider business mailing address

70 NE 94TH ST
MIAMI SHORES FL
33138-2820
US

V. Phone/Fax

Practice location:
  • Phone: 305-324-4455
  • Fax: 305-575-3222
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberME 82122
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: