Provider Demographics
NPI:1134888936
Name:SUAREZ RODRIGUEZ, YARITZA GLORIANA (MD)
Entity type:Individual
Prefix:
First Name:YARITZA
Middle Name:GLORIANA
Last Name:SUAREZ RODRIGUEZ
Suffix:
Gender:F
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:PO BOX 373245
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-3245
Mailing Address - Country:US
Mailing Address - Phone:787-718-6847
Mailing Address - Fax:
Practice Address - Street 1:64 CALLE JOSE CELSO BARBOSA S
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-4727
Practice Address - Country:US
Practice Address - Phone:787-738-1833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22589208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice