Provider Demographics
NPI:1609271469
Name:SUAREZ CORONA, ALEXANDER (PTA)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:SUAREZ CORONA
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8231 SW 30TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2428
Mailing Address - Country:US
Mailing Address - Phone:305-316-8852
Mailing Address - Fax:
Practice Address - Street 1:8231 SW 30TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2428
Practice Address - Country:US
Practice Address - Phone:305-316-8852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA25288225200000X
FLMA67502225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist