Provider Demographics
NPI:1528107398
Name:SUAREZ, JAIME (MD , DMD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:MD , DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 9717
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726
Mailing Address - Country:US
Mailing Address - Phone:787-750-6120
Mailing Address - Fax:787-750-6120
Practice Address - Street 1:LOS COLOBOS SHOPPING CENTER CINEMA BUILDING
Practice Address - Street 2:SUITE 208 65TH INFANTERY AVE. BO. CANOVANILLAS
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-750-6120
Practice Address - Fax:787-750-6120
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19501223S0112X
PR12966204E00000X
ARE-3338204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Not Answered204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery