Provider Demographics
NPI:1669409405
Name:SUAREZ, LEONIDES (MD)
Entity type:Individual
Prefix:DR
First Name:LEONIDES
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 1:2207 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7600
Mailing Address - Country:US
Mailing Address - Phone:561-965-8345
Mailing Address - Fax:561-965-8434
Practice Address - Street 1:2207 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33406-7600
Practice Address - Country:US
Practice Address - Phone:561-965-8345
Practice Address - Fax:561-965-8434
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0063618207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL374799900Medicaid
FL23957Medicare ID - Type Unspecified
FL374799900Medicaid