Healthcare Provider Details

I. General information

NPI: 1316718570
Provider Name (Legal Business Name): MALIK PAIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 NE MIAMI GARDENS DR STE 155
NORTH MIAMI BEACH FL
33179-4747
US

IV. Provider business mailing address

1380 NE MIAMI GARDENS DR STE 155
NORTH MIAMI BEACH FL
33179-4747
US

V. Phone/Fax

Practice location:
  • Phone: 305-902-1663
  • Fax:
Mailing address:
  • Phone: 305-902-1663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALI S MALIK
Title or Position: OWNER
Credential: DO
Phone: 305-761-6850