Provider Demographics
NPI:1578264537
Name:SUAREZ RUIZ, YANET
Entity Type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:SUAREZ RUIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 HARDING AVE APT 511
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-3851
Mailing Address - Country:US
Mailing Address - Phone:786-399-0847
Mailing Address - Fax:
Practice Address - Street 1:6050 W 20TH AVE STE 2001
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-2605
Practice Address - Country:US
Practice Address - Phone:786-584-5086
Practice Address - Fax:786-584-5061
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11019972363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty