Provider Demographics
NPI:1225722978
Name:SUAZO, CARLOS A (LMHC)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:A
Last Name:SUAZO
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8015 SW 107TH AVE APT 315
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4824
Mailing Address - Country:US
Mailing Address - Phone:787-244-8400
Mailing Address - Fax:
Practice Address - Street 1:8015 SW 107TH AVE APT 315
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4824
Practice Address - Country:US
Practice Address - Phone:787-244-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21234101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health