Provider Demographics
NPI:1891539532
Name:SUAREZ JUSTO, CESAR ERNESTO
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:ERNESTO
Last Name:SUAREZ JUSTO
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 1:10765 SW 226TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170-6577
Mailing Address - Country:US
Mailing Address - Phone:786-451-6657
Mailing Address - Fax:
Practice Address - Street 1:10765 SW 226TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-6577
Practice Address - Country:US
Practice Address - Phone:786-451-6657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician