Healthcare Provider Details

I. General information

NPI: 1215724133
Provider Name (Legal Business Name): ELITE PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 NW 57TH AVE # 200-14
MIAMI FL
33126-2018
US

IV. Provider business mailing address

815 NW 57TH AVE # 200-14
MIAMI FL
33126-2018
US

V. Phone/Fax

Practice location:
  • Phone: 786-234-5723
  • Fax: 813-582-7170
Mailing address:
  • Phone: 786-234-5723
  • Fax: 813-582-7170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: EDUARDO R SUAREZ
Title or Position: OWNER
Credential:
Phone: 786-234-5723