Provider Demographics
NPI:1659341550
Name:SUAREZ CASTRO, JOSE E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:E
Last Name:SUAREZ CASTRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 AVENIDA LAS CUMBRES KM 1.2 SUITE 17
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970
Mailing Address - Country:US
Mailing Address - Phone:787-250-7676
Mailing Address - Fax:787-756-5210
Practice Address - Street 1:10 AVENIDA LAS CUMBRES KM 1.2 SUITE 17
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00970
Practice Address - Country:US
Practice Address - Phone:787-250-7676
Practice Address - Fax:787-756-5210
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5933174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC78179Medicare UPIN
PR26161BMedicare ID - Type Unspecified