Provider Demographics
NPI:1093205601
Name:SUAREZ, ALEXANDER ENRIQUE JR (RBT)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:ENRIQUE
Last Name:SUAREZ
Suffix:JR
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 NW 122 CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182
Mailing Address - Country:US
Mailing Address - Phone:786-218-2156
Mailing Address - Fax:
Practice Address - Street 1:9507 SW 160TH ST
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-3372
Practice Address - Country:US
Practice Address - Phone:786-277-1571
Practice Address - Fax:305-328-6989
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician