Provider Demographics
NPI:1760853865
Name:SUAREZ, REYNALDO I (CNMT)
Entity Type:Individual
Prefix:
First Name:REYNALDO
Middle Name:I
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:CNMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:398 E ALTAMONTE DR
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4402
Mailing Address - Country:US
Mailing Address - Phone:407-331-9355
Mailing Address - Fax:
Practice Address - Street 1:398 E ALTAMONTE DR
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-4402
Practice Address - Country:US
Practice Address - Phone:407-331-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCRT818532471N0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine Technology