Provider Demographics
NPI:1689893968
Name:AYRIS, DAVID MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:AYRIS
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 1:415 N DIXIE AVE
Mailing Address - Street 2:
Mailing Address - City:FRUITLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:34731-2412
Mailing Address - Country:US
Mailing Address - Phone:352-787-0404
Mailing Address - Fax:352-787-0404
Practice Address - Street 1:415 N DIXIE AVE
Practice Address - Street 2:
Practice Address - City:FRUITLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:34731-2412
Practice Address - Country:US
Practice Address - Phone:352-787-0404
Practice Address - Fax:352-787-0404
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7681111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55932OtherBCBS
FL55932OtherBCBS
FLE3036Medicare ID - Type Unspecified