Healthcare Provider Details

I. General information

NPI: 1235390725
Provider Name (Legal Business Name): SOFIA CONSUELO SUAREZ P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N US HIGHWAY 441 STE 552
THE VILLAGES FL
32159-8987
US

IV. Provider business mailing address

12340 SE 100TH CT
BELLEVIEW FL
34420-7121
US

V. Phone/Fax

Practice location:
  • Phone: 352-751-2862
  • Fax: 855-420-1047
Mailing address:
  • Phone: 305-505-8786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT24054
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: