Healthcare Provider Details

I. General information

NPI: 1134008451
Provider Name (Legal Business Name): RAMIRO AGUIRRE SUAREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

389 S 900 E
SALT LAKE CITY UT
84102-2310
US

IV. Provider business mailing address

1086 E 4500 S
MILLCREEK UT
84117-4152
US

V. Phone/Fax

Practice location:
  • Phone: 385-282-2400
  • Fax:
Mailing address:
  • Phone: 801-870-0220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11767372-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: