Provider Demographics
NPI:1336808138
Name:SUAREZ MEDINA, HECTOR LUIS
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:LUIS
Last Name:SUAREZ MEDINA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 CALLE FLORIDA
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-3452
Mailing Address - Country:US
Mailing Address - Phone:787-628-3187
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL BUEN SAMARITANO AVENIDA SEVERIANO CUEVAS #18
Practice Address - Street 2:KM. 141.1 BO. CAIMITAL BAJO
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-658-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-09
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR24091208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program