Provider Demographics
NPI:1932848868
Name:SUAREZ RODRIGUEZ, JOSE NELSON (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:NELSON
Last Name:SUAREZ RODRIGUEZ
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 1912
Mailing Address - Street 2:
Mailing Address - City:BOQUERON
Mailing Address - State:PR
Mailing Address - Zip Code:00622-1912
Mailing Address - Country:US
Mailing Address - Phone:787-590-1655
Mailing Address - Fax:
Practice Address - Street 1:URB ATENAS CALLE HERNANDEZ CARRION
Practice Address - Street 2:CARR #2 INT 668
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:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program