Provider Demographics
NPI:1598266298
Name:SUAREZ, GUILLERMO (ARNP)
Entity Type:Individual
Prefix:
First Name:GUILLERMO
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8934 NW 146TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018-7306
Mailing Address - Country:US
Mailing Address - Phone:786-487-1259
Mailing Address - Fax:
Practice Address - Street 1:4410 W 16TH AVE STE 26
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7146
Practice Address - Country:US
Practice Address - Phone:305-822-8883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3358452363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily