Provider Demographics
NPI:1477721447
Name:MINIKHANOV, ALIK (DACM, AP)
Entity Type:Individual
Prefix:
First Name:ALIK
Middle Name:
Last Name:MINIKHANOV
Suffix:
Gender:M
Credentials:DACM, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4708 ARBORETUM CIR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-7457
Mailing Address - Country:US
Mailing Address - Phone:239-380-3595
Mailing Address - Fax:
Practice Address - Street 1:826 ANCHOR RODE DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-2739
Practice Address - Country:US
Practice Address - Phone:239-322-3817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000855171100000X
FLAP4191171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist