Provider Demographics
NPI:1750799169
Name:SUAREZ, CRISBEL
Entity type:Individual
Prefix:
First Name:CRISBEL
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17570 ATLANTIC BLVD APT 414
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2838
Mailing Address - Country:US
Mailing Address - Phone:305-504-1749
Mailing Address - Fax:
Practice Address - Street 1:17570 ATLANTIC BLVD APT 414
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-2838
Practice Address - Country:US
Practice Address - Phone:305-504-1749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 247200000X
FL1-21-56912103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other