Individual
ENRIQUE E SUAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGENT
Contact information
Practice address
6625 MIAMI LAKES DR, MIAMI LAKES, FL 33014-2708
(786) 252-9650
Mailing address
17400 NW 68TH AVE APT 309, HIALEAH, FL 33015-4073
(786) 252-9650
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
W453314
FL
Other
Enumeration date
10/11/2023
Last updated
10/11/2023
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