MEDICARE: GILBERTO SUAREZ JR.

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1922561950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GILBERTO SUAREZ JR.

Provider Business Mailing Address
First Line	:	7312 W CHEYENNE AVE STE 4
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7425
Country	:	US
Telephone Number	:	702-877-9977
Fax Number	:	702-899-5501

Provider Business Practice Location Address
First Line	:	7312 W CHEYENNE AVE STE 4
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7425
Country	:	US
Telephone Number	:	702-877-9977
Fax Number	:	702-899-5501

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	KELLY CUCKLER
Credential	:
Telephone Number	:	702-877-9977

Provider Enumeration Date	:	04/08/2019
Last Update Date	:	01/02/2020

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Directions to “GILBERTO SUAREZ JR. ” Practice Location

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