Provider Demographics
NPI:1528032968
Name:CANDELARIO, SUZETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZETTE
Middle Name:
Last Name:CANDELARIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2639 CALLE PONTEVEDRA
Mailing Address - Street 2:URB. ANAIDA
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-3619
Mailing Address - Country:US
Mailing Address - Phone:787-848-8614
Mailing Address - Fax:
Practice Address - Street 1:9 CALLE LA CRUZ
Practice Address - Street 2:CENTRO SAN CRISTOBAL
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-2426
Practice Address - Country:US
Practice Address - Phone:787-837-2265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9724208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics