Provider Demographics
NPI:1093005134
Name:SUAREZ, ANDREA LUISA
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LUISA
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3329 E BAYAUD AVE APT 918A
Mailing Address - Street 2:#918A
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2952
Mailing Address - Country:US
Mailing Address - Phone:970-978-4906
Mailing Address - Fax:
Practice Address - Street 1:1721 E 19TH AVE
Practice Address - Street 2:SUITE 520
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1251
Practice Address - Country:US
Practice Address - Phone:303-869-2278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program