Provider Demographics
NPI:1457803637
Name:SUAREZ, MAKY ANTUANET (APRN)
Entity Type:Individual
Prefix:MS
First Name:MAKY
Middle Name:ANTUANET
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13727 SW 152 STREET
Mailing Address - Street 2:#1107
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1106
Mailing Address - Country:US
Mailing Address - Phone:786-575-2010
Mailing Address - Fax:
Practice Address - Street 1:13727 SW 152 STREET
Practice Address - Street 2:#1107
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-1106
Practice Address - Country:US
Practice Address - Phone:786-575-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2022-01-05
Deactivation Date:2020-02-29
Deactivation Code:
Reactivation Date:2021-12-29
Provider Licenses
StateLicense IDTaxonomies
FL9311235363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner