Provider Demographics
NPI:1558634238
Name:ARES, ANGEL L (DC)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:L
Last Name:ARES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21309 NW 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2112
Mailing Address - Country:US
Mailing Address - Phone:305-654-9797
Mailing Address - Fax:305-652-1792
Practice Address - Street 1:21309 NW 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-2112
Practice Address - Country:US
Practice Address - Phone:305-654-9797
Practice Address - Fax:305-652-1792
Is Sole Proprietor?:No
Enumeration Date:2012-02-11
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10554111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor