MEDICARE: CARLOS PEDRO GONZALEZ-SUAREZ M.D.

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	0038717	FL

General Provider Information

NPI Number	:	1487778908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS PEDRO GONZALEZ-SUAREZ M.D.

Provider Business Mailing Address
First Line	:	1500 SAN REMO AVE
Second Line	:	SUITE 205
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-3043
Country	:	US
Telephone Number	:	305-669-6800
Fax Number	:	305-669-0737

Provider Business Practice Location Address
First Line	:	1500 SAN REMO AVE
Second Line	:	SUITE 205
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-3043
Country	:	US
Telephone Number	:	305-669-6800
Fax Number	:	305-669-0737

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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