Provider Demographics
NPI:1770968901
Name:SUAREZ, ANYLEC
Entity type:Individual
Prefix:
First Name:ANYLEC
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 1:2521 NW 140TH ST
Mailing Address - Street 2:
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33054-4062
Mailing Address - Country:US
Mailing Address - Phone:786-314-4063
Mailing Address - Fax:
Practice Address - Street 1:17773 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-3924
Practice Address - Country:US
Practice Address - Phone:954-589-2347
Practice Address - Fax:954-301-2246
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
FL0-17-7622106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst