Individual provider Active NPI

Suzette Mollenido Suarez, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Florence, SC
National Provider Identifier
1336901362
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06230876 Issued in SC
Practice address
4011 Lake Russell Dr
Florence, SC 29501-8147
Phone
(843) 861-2120
NPI assigned
Jan 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F06230876 SC Primary

Addresses

Primary practice location

4011 Lake Russell Dr
Florence, SC 29501-8147

Mailing address

4011 Lake Russell Dr
Florence, SC 29501-8147
Phone (843) 861-2120

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
F06230876SCMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1336901362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 LAKE RUSSELL DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295018147",
            "telephone_number": "843-861-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 LAKE RUSSELL DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295018147",
            "telephone_number": "843-861-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAREZ",
        "first_name": "SUZETTE",
        "middle_name": "MOLLENIDO",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "F06230876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.