Provider Demographics
NPI:1235688607
Name:LINARES SUAREZ, PAVEL
Entity Type:Individual
Prefix:
First Name:PAVEL
Middle Name:
Last Name:LINARES SUAREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CLOVER PARK DR
Mailing Address - Street 2:APT 4
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-4520
Mailing Address - Country:US
Mailing Address - Phone:585-224-5666
Mailing Address - Fax:
Practice Address - Street 1:11 CLOVER PARK DR
Practice Address - Street 2:APT 4
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-4520
Practice Address - Country:US
Practice Address - Phone:585-224-5666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY715859163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse