Provider Demographics
NPI:1508550336
Name:ARMADA SUAREZ, SERGIO C
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:C
Last Name:ARMADA 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 1:995 SW 84TH AVE APT 216
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4174
Mailing Address - Country:US
Mailing Address - Phone:786-448-2885
Mailing Address - Fax:
Practice Address - Street 1:995 SW 84TH AVE APT 216
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4174
Practice Address - Country:US
Practice Address - Phone:786-448-2885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-277316106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty