Provider Demographics
NPI:1871366260
Name:SUAREZ, DIANET SR
Entity type:Individual
Prefix:
First Name:DIANET
Middle Name:
Last Name:SUAREZ
Suffix:SR
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 1:8621 NW 26TH PL
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-2921
Mailing Address - Country:US
Mailing Address - Phone:954-901-7677
Mailing Address - Fax:
Practice Address - Street 1:8621 NW 26TH PL
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-2921
Practice Address - Country:US
Practice Address - Phone:954-901-7677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician