Provider Demographics
NPI:1861435588
Name:SUAREZ, RAFAEL ENRIQUE (DMD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:ENRIQUE
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR. 129, KM 5.2, BO. HATO ARRIBA
Mailing Address - Street 2:CALLE A, #149 SUITE #2, EL PARAISO
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-816-1041
Mailing Address - Fax:787-816-1041
Practice Address - Street 1:CARR. 129, KM 5.2, BO. HATO ARRIBA
Practice Address - Street 2:CALLE A, #149 SUITE #2, EL PARAISO
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-816-1041
Practice Address - Fax:787-816-1041
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR26461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice