MEDICARE: MIGUEL BORIS 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	343900000X	Non-emergency Medical Transport (VAN)	46021	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	82-1759294	OTHER	FL	O
2	82-1759294	OTHER	FL	NO

General Provider Information

NPI Number	:	1619546926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIGUEL BORIS SUAREZ

Provider Business Mailing Address
First Line	:	2020 SW 103RD CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-7320
Country	:	US
Telephone Number	:	786-630-0853
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 SW 103RD CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-7320
Country	:	US
Telephone Number	:	786-630-0853
Fax Number	:

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

Provider Enumeration Date	:	06/21/2021
Last Update Date	:	06/23/2021

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Directions to “ MIGUEL BORIS SUAREZ ” Practice Location

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