Individual provider Active NPI

Angela Catalina Botero Suarez, D.D.S

  • Dentist
  • St Petersburg, FL
National Provider Identifier
1609116813
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
61835 Issued in CA
Practice address
132 Mirror Lake Dr N
Saint Petersburg, FL 33701-3222
Phone
(714) 534-3535
NPI assigned
Feb 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN27620 FL
Dentist 122300000X 61835 CA Primary

Addresses

Primary practice location

132 Mirror Lake Dr N
Saint Petersburg, FL 33701-3222

Mailing address

5659 Barletta Dr
Saint Cloud, FL 34771-9125
Phone (786) 301-6708

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
DN27620FLMDDentist

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1609116813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5659 BARLETTA DR",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347719125",
            "telephone_number": "786-301-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 MIRROR LAKE DR N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337013222",
            "telephone_number": "714-534-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTERO SUAREZ",
        "first_name": "ANGELA",
        "middle_name": "CATALINA",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-25",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN27620",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; 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.