MEDICARE: ANA SUAREZ MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	ME120211	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME120211	OTHER	FL	LICENSE

General Provider Information

NPI Number	:	1194197319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANA SUAREZ MD PA

Provider Business Mailing Address
First Line	:	1333 SW AXTELL AVE
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34953-5327
Country	:	US
Telephone Number	:	786-285-6410
Fax Number	:

Provider Business Practice Location Address
First Line	:	1333 SW AXTELL AVE
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34953-5327
Country	:	US
Telephone Number	:	786-285-6410
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANA SUAREZ
Credential	:	MD
Telephone Number	:	786-285-6410

Provider Enumeration Date	:	10/27/2015
Last Update Date	:	05/05/2016

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Directions to “ANA SUAREZ MD PA ” Practice Location

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