Provider Demographics
NPI:1750947248
Name:LIRIANO SUAREZ, MARCOS RAFAEL (MD)
Entity type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:RAFAEL
Last Name:LIRIANO 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:PO BOX 1142
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-1142
Mailing Address - Country:US
Mailing Address - Phone:787-621-3700
Mailing Address - Fax:
Practice Address - Street 1:CALLE HERHANDEZ CARRION URB ATENAS
Practice Address - Street 2:DEPTO EDUCACION MEDICA
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-621-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21325208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice