Provider Demographics
NPI:1669259305
Name:SUAREZ, EVERINA
Entity type:Individual
Prefix:
First Name:EVERINA
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9174 N MILITARY TRL
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-5974
Mailing Address - Country:US
Mailing Address - Phone:561-507-6765
Mailing Address - Fax:
Practice Address - Street 1:9174 N MILITARY TRL
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-5974
Practice Address - Country:US
Practice Address - Phone:561-507-6765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-296218106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician