Provider Demographics
NPI:1083020101
Name:SUAREZ, VANESSA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:MARIE
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 CALLE DE LA SANTISIMA TRINIDAD
Mailing Address - Street 2:URB SANTA CECILIA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-640-2171
Mailing Address - Fax:
Practice Address - Street 1:#101 CARR #1 DF-02635-1
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-744-2905
Practice Address - Fax:787-744-2936
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist