Provider Demographics
NPI:1023500998
Name:SUAREZ RODRIGUEZ, EMILIO MANUEL (SA-C)
Entity type:Individual
Prefix:
First Name:EMILIO
Middle Name:MANUEL
Last Name:SUAREZ RODRIGUEZ
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 ALTON RD APT 217
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-6725
Mailing Address - Country:US
Mailing Address - Phone:305-924-5568
Mailing Address - Fax:
Practice Address - Street 1:150 ALTON RD APT 217
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-6725
Practice Address - Country:US
Practice Address - Phone:305-924-5568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16-121246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant