Provider Demographics
NPI:1558797944
Name:DR ELLEN SUAREZ-PINZAS PSYD PA
Entity Type:Organization
Organization Name:DR ELLEN SUAREZ-PINZAS PSYD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SUAREZ-PINZAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:863-225-4153
Mailing Address - Street 1:5424 STRICKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33812-4264
Mailing Address - Country:US
Mailing Address - Phone:863-644-8470
Mailing Address - Fax:
Practice Address - Street 1:5424 STRICKLAND AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33812-4264
Practice Address - Country:US
Practice Address - Phone:863-644-8470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8537251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health