Healthcare Provider Details

I. General information

NPI: 1871087684
Provider Name (Legal Business Name): YOHJAN SUAREZ-MARTINEZ ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 06/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6221 NW 36 TH ST
MIAMI FL
33166
US

IV. Provider business mailing address

1229 NW 6TH ST APT 2
MIAMI FL
33125-4784
US

V. Phone/Fax

Practice location:
  • Phone: 305-871-3627
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number9429411
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: