Provider Demographics
NPI:1558753475
Name:SUAREZ, XIOMARA DENISSE (MS)
Entity Type:Individual
Prefix:MS
First Name:XIOMARA
Middle Name:DENISSE
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3872 SW 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3655
Mailing Address - Country:US
Mailing Address - Phone:305-978-3581
Mailing Address - Fax:
Practice Address - Street 1:336 NW 5TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33128-1616
Practice Address - Country:US
Practice Address - Phone:305-374-1065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-02
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH11069101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health