Individual provider Active NPI

Jose H Perez Suarez, M.D.

  • Family Medicine Physician
  • Umatilla, FL
National Provider Identifier
1154397461
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME56328 Issued in FL
Practice address
249 E Collins St
Umatilla, FL 32784-8383
Phone
(352) 483-7984
Fax
(352) 589-6496
NPI assigned
Feb 27, 2006
Last updated
Jan 17, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME005628 FL
Family Medicine Physician 207Q00000X ME56328 FL Primary

Addresses

Primary practice location

249 E Collins St
Umatilla, FL 32784-8383

Mailing address

16140 US Highway 441
Eustis, FL 32726-6508
Phone (352) 483-7984

Other identifiers 1

IdentifierTypeStateIssuer
061377100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME005628FLMDFamily Medicine Physician
ME56328FLMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1154397461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16140 US HIGHWAY 441",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266508",
            "telephone_number": "352-483-7984",
            "fax_number": "352-589-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 E COLLINS ST",
            "city": "UMATILLA",
            "state": "FL",
            "postal_code": "327848383",
            "telephone_number": "352-483-7984",
            "fax_number": "352-589-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ SUAREZ",
        "first_name": "JOSE",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME005628",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME56328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "061377100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Umatilla, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.