Provider Demographics
NPI:1043949191
Name:SUAREZ RAMIREZ, RAFAEL ANTONIO (DMD)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:ANTONIO
Last Name:SUAREZ RAMIREZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 W 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-5331
Mailing Address - Country:US
Mailing Address - Phone:786-837-3801
Mailing Address - Fax:
Practice Address - Street 1:7450 W 29TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-5331
Practice Address - Country:US
Practice Address - Phone:786-837-3801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL269211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice