Healthcare Provider Details

I. General information

NPI: 1508913526
Provider Name (Legal Business Name): MILDRED SUAREZ M.S., C.C.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MILLIE MARTINEZ SUAREZ M.S., C.C.C.

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 03/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8510 SW 8TH ST
MIAMI FL
33144-4053
US

IV. Provider business mailing address

8510 SW 8TH ST
MIAMI FL
33144-4053
US

V. Phone/Fax

Practice location:
  • Phone: 305-266-5353
  • Fax: 305-266-6550
Mailing address:
  • Phone: 305-266-5353
  • Fax: 305-266-6550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA 1502
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License NumberSA1502
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: