Provider Demographics
NPI:1891229571
Name:SUAREZ SANCHEZ, DANIEL SR
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:SUAREZ SANCHEZ
Suffix:SR
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 1:4500 W 16TH AVE APT 412A
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2910
Mailing Address - Country:US
Mailing Address - Phone:786-400-5792
Mailing Address - Fax:
Practice Address - Street 1:144 NW 11TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4328
Practice Address - Country:US
Practice Address - Phone:786-400-5792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst