Basic Information
| Provider Information | |||||||||
| NPI: | 1992095004 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SUAREZ FERNANDEZ | ||||||||
| FirstName: | JOMAR | ||||||||
| MiddleName: | PAOLO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 145 | ||||||||
| Address2: | |||||||||
| City: | BLACK HAWK | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804220145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037246018 | ||||||||
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| Practice Location | |||||||||
| Address1: | 13001 E 17TH PL | ||||||||
| Address2: | UNIVERSITY OF COLORADO DENVER SCHOOL OF MEDICINE GME | ||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800452570 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037246031 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2011 | ||||||||
| LastUpdateDate: | 11/13/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | DR.0053808 | CO | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.