Provider Demographics
NPI:1437849932
Name:MORALES SUAREZ, MAIKEL (SA-C)
Entity Type:Individual
Prefix:
First Name:MAIKEL
Middle Name:
Last Name:MORALES SUAREZ
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:MAIKEL
Other - Middle Name:
Other - Last Name:MORALES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SA-C
Mailing Address - Street 1:PO BOX 936535
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-6535
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1995 E OAKLAND PARK BLVD STE 310
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1138
Practice Address - Country:US
Practice Address - Phone:954-971-6146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZC0007X
FL246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant