Provider Demographics
NPI:1851764641
Name:SUAREZ, VICTOR (TT)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:TT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4935 SW 111TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-6134
Mailing Address - Country:US
Mailing Address - Phone:305-300-8712
Mailing Address - Fax:305-248-1009
Practice Address - Street 1:4935 SW 111TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-6134
Practice Address - Country:US
Practice Address - Phone:305-300-8712
Practice Address - Fax:305-248-1009
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-03
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTT 16065227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified