Provider Demographics
NPI:1679517692
Name:SUAREZ, CARMEN M (MD)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:M
Last Name:SUAREZ
Suffix:
Gender:F
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:F1 CALLE FRANCIA
Mailing Address - Street 2:GARDEN COURT
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2015
Mailing Address - Country:US
Mailing Address - Phone:787-782-4886
Mailing Address - Fax:787-740-4343
Practice Address - Street 1:31-43 AVE MAIN
Practice Address - Street 2:SANTA ROSA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-6531
Practice Address - Country:US
Practice Address - Phone:787-798-1300
Practice Address - Fax:787-740-0417
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9294174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE 83964Medicare ID - Type Unspecified