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General NPI Number Information
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NPI Number | 1639715741
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Entity Type | Individual
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Provider Name | INGRID MARIA SUAZO APRN
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Gender | Female
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Dates
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Enumeration Date | 11/24/2019
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 14615 CRESCENT ROCK DR
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City | WIMAUMA
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State | FL
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Zip | 33598-6186
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Country | US
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Telephone | 813-898-3536
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Fax |
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Provider Business Mailing Address
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Address Line | 14615 CRESCENT ROCK DR
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City | WIMAUMA
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State | FL
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Zip | 33598-6186
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Country | US
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Telephone | 813-453-0028
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Fax | 205-961-5119
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11024608
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP95029528
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License Number State | CA
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