Healthcare Provider Details

I. General information

NPI: 1740136282
Provider Name (Legal Business Name): MARLIN SUAREZ LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

5117 JONES RD
SAINT CLOUD FL
34771-9543
US

IV. Provider business mailing address

5117 JONES RD
SAINT CLOUD FL
34771-9543
US

V. Phone/Fax

Practice location:
  • Phone: 914-522-2834
  • Fax:
Mailing address:
  • Phone: 914-522-2834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA102753
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: