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General NPI Number Information
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NPI Number | 1790915304
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Entity Type | Organization
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Legal Business Name | ALEISHA OLBY-CANIK DO LLC
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Dates
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Enumeration Date | 07/16/2009
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Last Update Date | 12/30/2009
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Provider Practice Location Address
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Address Line | 2900 N MILITARY TRL SUITE 245
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City | BOCA RATON
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State | FL
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Zip | 33431-6365
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Country | US
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Telephone | 561-994-2007
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Fax | 561-994-2003
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Provider Business Mailing Address
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Address Line | 200 SE 3RD ST
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City | POMPANO BEACH
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State | FL
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Zip | 33060-7118
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Country | US
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Telephone | 954-449-3763
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEISHA A OLBY
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Credential | DO
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Telephone | 954-449-3763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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