Provider Demographics
NPI:1942523956
Name:SUAREZ, MARLENE
Entity Type:Individual
Prefix:MRS
First Name:MARLENE
Middle Name:
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 1:13021 SW 84TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4321
Mailing Address - Country:US
Mailing Address - Phone:305-227-2740
Mailing Address - Fax:305-225-1143
Practice Address - Street 1:14375 SW 120TH ST STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7195
Practice Address - Country:US
Practice Address - Phone:305-227-2740
Practice Address - Fax:305-225-1143
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA 20085374U00000X
FLCNA20085172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No172V00000XOther Service ProvidersCommunity Health Worker