Healthcare Provider Details

I. General information

NPI: 1275683195
Provider Name (Legal Business Name): CARMEN I SUAREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SUITE 202 PASEO SAN PABLO # 100 DR ARTURO CADILLA BUILDING
BAYAMON PR
00961-3138
US

IV. Provider business mailing address

PO BOX 3138
BAYAMON PR
00960-3138
US

V. Phone/Fax

Practice location:
  • Phone: 787-786-6792
  • Fax: 787-798-5253
Mailing address:
  • Phone: 787-786-6792
  • Fax: 787-798-5253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number11663
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: