Provider Demographics
NPI:1689482523
Name:SUAREZ PEREZ, RICARDO ALFREDO (APRN/FNP)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:ALFREDO
Last Name:SUAREZ PEREZ
Suffix:
Gender:M
Credentials:APRN/FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 NW 87TH AVE APT 206
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-3423
Mailing Address - Country:US
Mailing Address - Phone:786-675-2363
Mailing Address - Fax:
Practice Address - Street 1:3824 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4127
Practice Address - Country:US
Practice Address - Phone:305-643-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9607981163W00000X
FL11031634363L00000X
FLF02240508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner