Individual
IVAN MIKOLAENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5441 N UNIVERSITY DR STE 101, CORAL SPRINGS, FL 33067-4640
(954) 803-9002
(954) 933-2305
Mailing address
5441 N UNIVERSITY DR STE 101, CORAL SPRINGS, FL 33067-4640
(954) 803-9002
(954) 933-2305
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
0109542061
VA
2084N0400X
Neurology Physician
0116020711
VA
2084N0400X
Neurology Physician
Primary
ME131780
FL
2084V0102X
Vascular Neurology Physician
0116020711
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023231883
—
VA
Enumeration date
04/10/2007
Last updated
05/15/2025
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