Provider Demographics
NPI:1124442462
Name:SUAREZ ORTIZ, YOLISA ILEIN (MD)
Entity type:Individual
Prefix:
First Name:YOLISA
Middle Name:ILEIN
Last Name:SUAREZ ORTIZ
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 1:2095 CALLE MOTILLO
Mailing Address - Street 2:LOS CAOBOS
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2701
Mailing Address - Country:US
Mailing Address - Phone:787-246-1581
Mailing Address - Fax:
Practice Address - Street 1:2095 CALLE MOTILLO
Practice Address - Street 2:LOS CAOBOS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2701
Practice Address - Country:US
Practice Address - Phone:787-246-1581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18657208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice