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General NPI Number Information
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NPI Number | 1184447252
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Entity Type | Individual
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Provider Name | IVAN SUAREZ
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Gender | Male
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Dates
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Enumeration Date | 11/06/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 13115 W OKEECHOBEE RD STE 111-112
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-6041
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Country | US
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Telephone | 786-355-4722
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Fax | 786-953-8481
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Provider Business Mailing Address
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Address Line | 13115 W OKEECHOBEE RD STE 111-112
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-6041
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Country | US
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Telephone | 786-355-4722
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Fax | 786-953-8481
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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 | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State | FL
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