Provider Demographics
NPI:1295386092
Name:SUAREZ-PEREZ, JHON JAIRO (APRN)
Entity Type:Individual
Prefix:
First Name:JHON
Middle Name:JAIRO
Last Name:SUAREZ-PEREZ
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15003 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4365
Mailing Address - Country:US
Mailing Address - Phone:954-608-4600
Mailing Address - Fax:
Practice Address - Street 1:15003 SW 21ST ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4365
Practice Address - Country:US
Practice Address - Phone:954-608-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11004191363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health