Provider Demographics
NPI:1699243261
Name:DIEGUEZ SUAREZ, MILAGROS DE LA CARIDA
Entity type:Individual
Prefix:MISS
First Name:MILAGROS
Middle Name:DE LA CARIDA
Last Name:DIEGUEZ 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 1:2870 S DECATUR BLVD APT 21
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-5570
Mailing Address - Country:US
Mailing Address - Phone:702-903-0698
Mailing Address - Fax:
Practice Address - Street 1:2870 S DECATUR BLVD APT 21
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-5570
Practice Address - Country:US
Practice Address - Phone:702-903-0698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst