Healthcare Provider Details

I. General information

NPI: 1184588089
Provider Name (Legal Business Name): STEPHANY SUAREZ AYUSO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDIFICIO JESUS T. PINEIRO, APARTADO 8
CAROLINA PR
00986
US

IV. Provider business mailing address

HC 3 BOX 19164
RIO GRANDE PR
00745-9786
US

V. Phone/Fax

Practice location:
  • Phone: 787-626-3322
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: