Provider Demographics
NPI:1023572336
Name:LISSET MARIA SUAREZ. MD,PA.
Entity Type:Organization
Organization Name:LISSET MARIA SUAREZ. MD,PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISSET
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-964-8080
Mailing Address - Street 1:8316 HANLEY RD STE 1
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-2284
Mailing Address - Country:US
Mailing Address - Phone:813-964-8080
Mailing Address - Fax:
Practice Address - Street 1:8316 HANLEY RD STE 1
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-2284
Practice Address - Country:US
Practice Address - Phone:813-964-8080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LISEET MARIA SUAREZ MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-31
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty