Provider Demographics
NPI:1821543828
Name:SUAREZ REHABILITATION ASSOCIATES
Entity type:Organization
Organization Name:SUAREZ REHABILITATION ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:413-246-1445
Mailing Address - Street 1:5120 BAYOU BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2193
Mailing Address - Country:US
Mailing Address - Phone:413-246-1445
Mailing Address - Fax:
Practice Address - Street 1:5120 BAYOU BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2193
Practice Address - Country:US
Practice Address - Phone:413-246-1445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA-9434261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech