Provider Demographics
NPI:1669461042
Name:SUAREZ BARCELO, MANUEL ANTONIO (MD)
Entity Type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:ANTONIO
Last Name:SUAREZ BARCELO
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 1:12550 BISCAYNE BLVD STE 226
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2501
Mailing Address - Country:US
Mailing Address - Phone:305-945-2411
Mailing Address - Fax:305-945-2412
Practice Address - Street 1:12550 BISCAYNE BLVD STE 226
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2501
Practice Address - Country:US
Practice Address - Phone:305-945-2411
Practice Address - Fax:305-945-2412
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61788207R00000X
NC200500847207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL059823200Medicaid
FL059823200Medicaid