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General NPI Number Information
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NPI Number | 1134455421
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Entity Type | Individual
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Provider Name | TITO SUERO SALVADOR M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/22/2009
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 11750 SW 40TH ST
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City | MIAMI
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State | FL
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Zip | 33175
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Country | US
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Telephone | 305-227-5544
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Fax |
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Provider Business Mailing Address
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Address Line | 9448 SW 170TH CT
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City | MIAMI
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State | FL
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Zip | 33196-2958
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Country | US
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Telephone | 787-529-0204
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME113385
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2017035456
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License Number State | MO
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