Provider Demographics
NPI:1700826344
Name:BAEZ SUAREZ, JULIO MANUEL (MD)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:MANUEL
Last Name:BAEZ SUAREZ
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:PO BOX 5100
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-5100
Mailing Address - Country:US
Mailing Address - Phone:787-746-2065
Mailing Address - Fax:
Practice Address - Street 1:CALLE MUNOZ RIVERA NUM 2
Practice Address - Street 2:PROFESSIONAL CENTER BUILDING SUITE 303
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0000
Practice Address - Country:US
Practice Address - Phone:787-746-2065
Practice Address - Fax:787-746-2085
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10027207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6920003OtherHUMANA INSURANCE
PR83369OtherTRIPLE S
PRSE2465OtherPALIC PROVIDER
PR7004OtherFIRST MEDICAL
PR064978OtherCRUZ AZUL DE PR
PR220115OtherPREFERRED HEALTH
PR601298OtherMEDICARE Y MUCHO MAS
PR6920003OtherHUMANA HEALTH PLAN
PRF46129Medicare UPIN
PR220115OtherPREFERRED HEALTH