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NPI Code Detail

MEDICARE: DR. LILLIAN HADDOCK-SUAREZ M.D.

MEDICARE: DR. LILLIAN HADDOCK-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
1207RE0101XEndocrinology, Diabetes & Metabolism Physician1457PR

General Provider Information

NPI Number : 1841275104
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LILLIAN HADDOCK-SUAREZ M.D.
Provider Business Mailing Address
First Line : 402 CALLE MINERVA
Second Line : URB. DOS PINOS
City : SAN JUAN
State : PR
Zip : 00923-2312
Country : US
Telephone Number : 787-763-7109
Fax Number : 787-282-7665
Provider Business Practice Location Address
First Line : CENTRO DE DIABETES PARA PUERTO RICO
Second Line : PISO 1 EDIF. FARMACIA RCM, CENTRO MEDICO DE PR
City : RIO PIEDRAS
State : PR
Zip : 00935
Country : US
Telephone Number : 787-773-8283
Fax Number : 787-773-8303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2005
Last Update Date : 01/19/2011

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