Individual provider Active NPI

Enrique E Suarez, AGENT

  • Health Maintenance Organization
  • Miami Lakes, FL
National Provider Identifier
1689455099
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
W453314 Issued in FL
Practice address
6625 Miami Lakes Dr
Miami Lakes, FL 33014-2708
Phone
(786) 252-9650
NPI assigned
Oct 11, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X W453314 FL Primary

Addresses

Primary practice location

6625 Miami Lakes Dr
Miami Lakes, FL 33014-2708

Mailing address

17400 NW 68TH Ave Apt 309
Hialeah, FL 33015-4073
Phone (786) 252-9650

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
W453314FLMDHealth Maintenance Organization

NPI Registry JSON

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1689455099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17400 NW 68TH AVE APT 309",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330154073",
            "telephone_number": "786-252-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 MIAMI LAKES DR",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142708",
            "telephone_number": "786-252-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAREZ",
        "first_name": "ENRIQUE",
        "middle_name": "E",
        "credential": "AGENT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-11",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "FL",
            "license": "W453314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.