Healthcare Provider Details

I. General information

NPI: 1598913238
Provider Name (Legal Business Name): DINDO SUAREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2008
Last Update Date: 09/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 STURDY RD
VALPARAISO IN
46383-5921
US

IV. Provider business mailing address

251 STURDY RD
VALPARAISO IN
46383-5921
US

V. Phone/Fax

Practice location:
  • Phone: 219-462-6158
  • Fax: 219-464-0918
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: