Healthcare Provider Details

I. General information

NPI: 1528941507
Provider Name (Legal Business Name): LILIET OLIVERA SUAREZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7480 SW 40TH ST STE 430
MIAMI FL
33155-6630
US

IV. Provider business mailing address

19221 SW 125TH AVE
MIAMI FL
33177-6551
US

V. Phone/Fax

Practice location:
  • Phone: 786-536-4266
  • Fax: 786-536-9230
Mailing address:
  • Phone: 786-745-0948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11043089
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: