Provider Demographics
NPI:1275704017
Name:SUAREZ, HECTOR HENRY (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:HENRY
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1939 CRESTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5120
Mailing Address - Country:US
Mailing Address - Phone:407-690-1455
Mailing Address - Fax:352-432-3514
Practice Address - Street 1:1939 CRESTRIDGE DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-5120
Practice Address - Country:US
Practice Address - Phone:407-690-1455
Practice Address - Fax:352-432-3514
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA59557225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist