Healthcare Provider Details

I. General information

NPI: 1881672061
Provider Name (Legal Business Name): RITA SUINA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4351 E LOHMAN AVE SUITE 301
LAS CRUCES NM
88011-8259
US

IV. Provider business mailing address

4351 E LOHMAN AVE SUITE 301
LAS CRUCES NM
88011-8259
US

V. Phone/Fax

Practice location:
  • Phone: 505-532-8900
  • Fax: 505-532-8974
Mailing address:
  • Phone: 505-532-8900
  • Fax: 505-532-8974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number81-323
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: