Provider Demographics
NPI:1932574274
Name:CARLOS SUAREZ, MD, PLLC
Entity Type:Organization
Organization Name:CARLOS SUAREZ, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-992-6256
Mailing Address - Street 1:29 COMMONWEALTH AVE
Mailing Address - Street 2:SUITE 906
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2349
Mailing Address - Country:US
Mailing Address - Phone:617-992-6256
Mailing Address - Fax:781-219-4200
Practice Address - Street 1:29 COMMONWEALTH AVE
Practice Address - Street 2:SUITE 906
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2349
Practice Address - Country:US
Practice Address - Phone:617-992-6256
Practice Address - Fax:781-219-4200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-12
Last Update Date:2015-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2364752084P0800X, 2084P0802X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty