Provider Demographics
NPI:1982207890
Name:SUAREZ, JOYCE CABRERA
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:CABRERA
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 1:5985 W TROPICANA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-4814
Mailing Address - Country:US
Mailing Address - Phone:702-252-0031
Mailing Address - Fax:702-252-0456
Practice Address - Street 1:5985 W TROPICANA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-4814
Practice Address - Country:US
Practice Address - Phone:702-252-0031
Practice Address - Fax:702-252-0456
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-21
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV171023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy