Provider Demographics
NPI:1932514965
Name:SUAREZ, ROGELIO (MD)
Entity Type:Individual
Prefix:
First Name:ROGELIO
Middle Name:
Last Name: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 1:4306 ALTON RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2840
Mailing Address - Country:US
Mailing Address - Phone:305-535-3349
Mailing Address - Fax:305-535-3438
Practice Address - Street 1:4304 ALTON RD
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2885
Practice Address - Country:US
Practice Address - Phone:305-674-2876
Practice Address - Fax:305-674-2916
Is Sole Proprietor?:No
Enumeration Date:2014-06-28
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN 19675390200000X
FLME1299892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program