Provider Demographics
NPI:1164695805
Name:SUAREZ, ANTONIO J (MD)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:J
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 1:8100 SW 10TH ST
Mailing Address - Street 2:SUITE 3350
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3279
Mailing Address - Country:US
Mailing Address - Phone:561-939-4097
Mailing Address - Fax:
Practice Address - Street 1:8100 SW 10TH ST
Practice Address - Street 2:SUITE 3350
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3279
Practice Address - Country:US
Practice Address - Phone:561-939-4097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108750207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003712100Medicaid