Provider Demographics
NPI:1043216344
Name:SUAREZ, ALBERTO (MD)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64701-1784
Mailing Address - Country:US
Mailing Address - Phone:816-380-3898
Mailing Address - Fax:816-887-2024
Practice Address - Street 1:2800 E ROCK HAVEN RD
Practice Address - Street 2:
Practice Address - City:HARRISONVILLE
Practice Address - State:MO
Practice Address - Zip Code:64701-4411
Practice Address - Country:US
Practice Address - Phone:816-380-3474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5B32207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOC50649Medicare UPIN