Provider Demographics
NPI:1851144133
Name:SUAREZ SANTANA, IVONNE MARIA
Entity Type:Individual
Prefix:
First Name:IVONNE
Middle Name:MARIA
Last Name:SUAREZ SANTANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5077 NW 7TH ST APT TS18
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3688
Mailing Address - Country:US
Mailing Address - Phone:786-454-6990
Mailing Address - Fax:
Practice Address - Street 1:9746 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7513
Practice Address - Country:US
Practice Address - Phone:786-717-7770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ11887235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist