Provider Demographics
NPI:1013906254
Name:PARTNERS OF INTERNAL MEDICINE PA
Entity type:Organization
Organization Name:PARTNERS OF INTERNAL MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:SUAREZ-BACCELO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-945-2411
Mailing Address - Street 1:12550 BISCAYNE BLVD #226
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181
Mailing Address - Country:US
Mailing Address - Phone:305-945-2411
Mailing Address - Fax:305-945-2412
Practice Address - Street 1:12550 BISCAYNE BLVD #226
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181
Practice Address - Country:US
Practice Address - Phone:305-945-2411
Practice Address - Fax:305-945-2412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260381100Medicaid
FL18399OtherBLUE CROSS BLUE SHIELD
FL18399OtherBLUE CROSS BLUE SHIELD