Provider Demographics
NPI:1851987671
Name:FERRER SUAREZ, PEDRO AGUSTIN (MD)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:AGUSTIN
Last Name:FERRER 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 1:8760 NW 97TH AVE
Mailing Address - Street 2:APT 213
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2594
Mailing Address - Country:US
Mailing Address - Phone:305-748-3022
Mailing Address - Fax:
Practice Address - Street 1:1738 W 49TH ST STE 10
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3457
Practice Address - Country:US
Practice Address - Phone:305-698-8432
Practice Address - Fax:305-698-8975
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1321208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR000OtherOTHER