Provider Demographics
NPI:1811284623
Name:ALES, CHRISTINE V (LMT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:V
Last Name:ALES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4151 81ST AVE N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2557
Mailing Address - Country:US
Mailing Address - Phone:727-251-6122
Mailing Address - Fax:
Practice Address - Street 1:9095 BELCHER RD
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-4423
Practice Address - Country:US
Practice Address - Phone:727-251-6122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL60716174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist