Provider Demographics
NPI:1013931427
Name:SUAREZ, MANUEL (MD)
Entity Type:Individual
Prefix:
First Name:MANUEL
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 1:7100 HOLLYWOOD BLVD STE 19
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-7355
Mailing Address - Country:US
Mailing Address - Phone:954-967-0107
Mailing Address - Fax:954-967-0109
Practice Address - Street 1:1435 W 49TH PL
Practice Address - Street 2:SUITE 207
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3197
Practice Address - Country:US
Practice Address - Phone:305-556-8556
Practice Address - Fax:305-556-6112
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 47423207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD64964Medicare UPIN
FL96855TMedicare ID - Type Unspecified