Provider Demographics
NPI:1093995235
Name:CANIK, ALEISHA (DO)
Entity Type:Individual
Prefix:
First Name:ALEISHA
Middle Name:
Last Name:CANIK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ALEISHA
Other - Middle Name:
Other - Last Name:OLBY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:200 SE 3RD ST
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-7118
Mailing Address - Country:US
Mailing Address - Phone:954-449-3763
Mailing Address - Fax:
Practice Address - Street 1:200 SE 3RD ST
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-7118
Practice Address - Country:US
Practice Address - Phone:954-449-3763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10217207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine