MEDICARE: NATALIE DIANE SUAREZ

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	363AM0700X	Medical Physician Assistant	PAT9108461	FL

General Provider Information

NPI Number	:	1376931972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE DIANE SUAREZ

Provider Business Mailing Address
First Line	:	6310 SUNSET DR
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-4823
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6310 SUNSET DR
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-4823
Country	:	US
Telephone Number	:	305-669-2799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2015
Last Update Date	:	02/13/2016

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Directions to “ NATALIE DIANE SUAREZ ” Practice Location

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