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General NPI Number Information
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NPI Number | 1013964683
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Entity Type | Organization
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Legal Business Name | GARDENS ID GROUP LLC
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 11211 PROSPERITY FARMS RD SUITE B-105
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-3446
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Country | US
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Telephone | 561-626-2914
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Fax |
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Provider Business Mailing Address
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Address Line | 11211 PROSPERITY FARMS RD SUITE B-105
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-3446
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Country | US
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Telephone | 561-626-2914
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Fax |
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | DR. ANDRES SUAREZ
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Credential | M.D.
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Telephone | 561-626-2914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME31932
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License Number State | FL
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