Provider Demographics
NPI:1275032864
Name:SUAREZ, LUIS FERNANDO
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:FERNANDO
Last Name: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 1:801 E MCKELLIPS RD APT 11B
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-1348
Mailing Address - Country:US
Mailing Address - Phone:928-581-7659
Mailing Address - Fax:
Practice Address - Street 1:6991 E CAMELBACK RD STE D300
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-2492
Practice Address - Country:US
Practice Address - Phone:623-349-1373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA110242355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant