Provider Demographics
NPI:1235987827
Name:MARES, BIANCA CELESTE (RN)
Entity type:Individual
Prefix:MISS
First Name:BIANCA
Middle Name:CELESTE
Last Name:MARES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1391 NW 136TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2800
Mailing Address - Country:US
Mailing Address - Phone:949-293-4760
Mailing Address - Fax:770-723-8757
Practice Address - Street 1:899 SAN REMO
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-8213
Practice Address - Country:US
Practice Address - Phone:949-293-4760
Practice Address - Fax:770-723-8757
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA756666163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management