Provider Demographics
NPI:1801771431
Name:SUAREZ LOPEZ, EDDY WILLIAN
Entity type:Individual
Prefix:
First Name:EDDY
Middle Name:WILLIAN
Last Name:SUAREZ LOPEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 SW 30TH AVE APT 125
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-4676
Mailing Address - Country:US
Mailing Address - Phone:786-857-8944
Mailing Address - Fax:
Practice Address - Street 1:1025 SW 30TH AVE APT 125
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4676
Practice Address - Country:US
Practice Address - Phone:786-857-8944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician