Provider Demographics
NPI:1417284340
Name:ALFREDO SUAREZ SARMIENTO MD PA
Entity Type:Organization
Organization Name:ALFREDO SUAREZ SARMIENTO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ SARMIENTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-445-9010
Mailing Address - Street 1:PO BOX 143578
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-3578
Mailing Address - Country:US
Mailing Address - Phone:305-445-9010
Mailing Address - Fax:305-442-0212
Practice Address - Street 1:2601 SW 37TH AVE
Practice Address - Street 2:SUITE 707
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2700
Practice Address - Country:US
Practice Address - Phone:305-445-9010
Practice Address - Fax:305-442-0212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-13
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0043030208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL069140200Medicaid
FLE34398Medicare UPIN
FL96439Medicare PIN