Provider Demographics
NPI:1538735162
Name:SUAREZ COLON, ANTONIO JUAN (PHARMD)
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:JUAN
Last Name:SUAREZ COLON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 SW 64TH AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4653
Mailing Address - Country:US
Mailing Address - Phone:787-585-0437
Mailing Address - Fax:
Practice Address - Street 1:2600 S DOUGLAS RD STE 308
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6134
Practice Address - Country:US
Practice Address - Phone:787-585-0437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS60172183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist