Provider Demographics
NPI:1891239877
Name:SUAREZ, MECHELLE BRIDGET
Entity Type:Individual
Prefix:
First Name:MECHELLE
Middle Name:BRIDGET
Last Name:SUAREZ
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 1:4651 NW 9TH DR
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1480
Mailing Address - Country:US
Mailing Address - Phone:772-985-6031
Mailing Address - Fax:
Practice Address - Street 1:4651 NW 9TH DR
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1480
Practice Address - Country:US
Practice Address - Phone:772-985-6031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other