Provider Demographics
NPI:1194188391
Name:SUAREZ BOHORQUEZ, MARIA JOSE (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:JOSE
Last Name:SUAREZ BOHORQUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 GAUSE BLVD STE 290
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2900
Mailing Address - Country:US
Mailing Address - Phone:985-280-7456
Mailing Address - Fax:985-280-6556
Practice Address - Street 1:1051 GAUSE BLVD STE 290
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2900
Practice Address - Country:US
Practice Address - Phone:985-280-7456
Practice Address - Fax:985-280-6556
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-04
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA328451207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease