Provider Demographics
NPI:1629150446
Name:ARIAS, ROBERTO M (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:M
Last Name:ARIAS
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 1:103 W OAK ST STE C
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4472
Mailing Address - Country:US
Mailing Address - Phone:407-847-8070
Mailing Address - Fax:407-847-6330
Practice Address - Street 1:103 W OAK ST STE C
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4472
Practice Address - Country:US
Practice Address - Phone:407-847-8070
Practice Address - Fax:407-847-6330
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5410040OtherINSURANCE #AETNA
FLK2189Medicare ID - Type UnspecifiedINSURANCE#
FLU55583Medicare UPIN
FL5575ZMedicare ID - Type UnspecifiedGROUP#