Provider Demographics
NPI:1336379387
Name:SUAREZ-LARIOT, REINALDO (PA)
Entity Type:Individual
Prefix:
First Name:REINALDO
Middle Name:
Last Name:SUAREZ-LARIOT
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3659 S MIAMI AVE
Mailing Address - Street 2:STE 2007
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4227
Mailing Address - Country:US
Mailing Address - Phone:305-856-6753
Mailing Address - Fax:305-856-6758
Practice Address - Street 1:3659 S MIAMI AVE
Practice Address - Street 2:STE 2007
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4227
Practice Address - Country:US
Practice Address - Phone:305-856-6753
Practice Address - Fax:305-856-6758
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103871363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9103871OtherPA LICENSE