Provider Demographics
NPI:1235390725
Name:SUAREZ, SOFIA CONSUELO (PT)
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:CONSUELO
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7442 ROOSEVELT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-5334
Mailing Address - Country:US
Mailing Address - Phone:954-962-8892
Mailing Address - Fax:
Practice Address - Street 1:3325 HOLLYWOOD BLVD
Practice Address - Street 2:SUITE # 200
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6999
Practice Address - Country:US
Practice Address - Phone:954-986-2299
Practice Address - Fax:954-986-0339
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24054225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist