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General NPI Number Information
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NPI Number | 1780976795
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Entity Type | Individual
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Provider Name | LIDIA SUAREZ D.D.S
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Gender | Female
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Dates
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Enumeration Date | 05/09/2011
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Last Update Date | 11/07/2018
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Provider Practice Location Address
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Address Line | 1840 FOREST HILL BLVD STE A3-4
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-6063
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Country | US
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Telephone | 561-249-6114
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Fax |
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Provider Business Mailing Address
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Address Line | 550 CYPRESS XING
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City | WELLINGTON
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State | FL
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Zip | 33414-6376
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Country | US
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Telephone | 305-904-6891
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN20107
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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