Provider Demographics
NPI:1316988918
Name:SUAREZ, ENRIQUE M (PHD)
Entity type:Individual
Prefix:DR
First Name:ENRIQUE
Middle Name:M
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 ALMERIA AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5703
Mailing Address - Country:US
Mailing Address - Phone:305-446-4064
Mailing Address - Fax:
Practice Address - Street 1:1450 MADRUGA AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3148
Practice Address - Country:US
Practice Address - Phone:305-667-4101
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 2933103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1-75146OtherBLUE CROSS/BLUE SHIELD