Provider Demographics
NPI:1861834202
Name:SUAREZ SOTOMAYOR, ROBERTO ALEXANDER
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:ALEXANDER
Last Name:SUAREZ SOTOMAYOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 S RAINBOW BLVD #270
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145
Mailing Address - Country:US
Mailing Address - Phone:702-365-0600
Mailing Address - Fax:702-365-0602
Practice Address - Street 1:6655 W SAHARA
Practice Address - Street 2:D106
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146
Practice Address - Country:US
Practice Address - Phone:702-365-0600
Practice Address - Fax:702-365-0602
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor