Provider Demographics
NPI:1144566944
Name:MALIK, ALI (DO)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:MALIK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1380 NE MIAMI GARDENS DR STE 155
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4747
Mailing Address - Country:US
Mailing Address - Phone:954-706-0454
Mailing Address - Fax:305-901-6238
Practice Address - Street 1:2820 NE 214TH ST STE 701
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1269
Practice Address - Country:US
Practice Address - Phone:954-458-1199
Practice Address - Fax:305-901-6238
Is Sole Proprietor?:No
Enumeration Date:2012-12-25
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12165208VP0014X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017486500Medicaid
FLKXP91OtherBCBS
FL017486500Medicaid