Healthcare Provider Details

I. General information

NPI: 1306522859
Provider Name (Legal Business Name): KEVIN-MITCHEL SUAREZ DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 SW 74TH CT STE 1408
MIAMI FL
33156-3173
US

IV. Provider business mailing address

7031 SW 62ND AVE
SOUTH MIAMI FL
33143-4701
US

V. Phone/Fax

Practice location:
  • Phone: 833-735-3668
  • Fax: 866-897-7014
Mailing address:
  • Phone: 305-284-7761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO4696
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: