Provider Demographics
NPI:1801574215
Name:SUAREZ RODRIGUEZ, NELVIS (DDS)
Entity type:Individual
Prefix:
First Name:NELVIS
Middle Name:
Last Name:SUAREZ RODRIGUEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 NE 212TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-1018
Mailing Address - Country:US
Mailing Address - Phone:786-804-9290
Mailing Address - Fax:
Practice Address - Street 1:9700 STIRLING RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-8092
Practice Address - Country:US
Practice Address - Phone:954-431-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL283341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice