Provider Demographics
NPI:1063988475
Name:COLAS SUAREZ, YOANKA
Entity type:Individual
Prefix:MISS
First Name:YOANKA
Middle Name:
Last Name:COLAS 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 1:713 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-1206
Mailing Address - Country:US
Mailing Address - Phone:239-850-4282
Mailing Address - Fax:
Practice Address - Street 1:5624 8TH ST W STE 116
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-6304
Practice Address - Country:US
Practice Address - Phone:239-491-2194
Practice Address - Fax:855-222-7760
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-23
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1063988475Medicaid
FL2398504282OtherPHONE