Provider Demographics
NPI:1316095565
Name:AKIMOV, SERGEY PAVLOVICH (MD)
Entity type:Individual
Prefix:DR
First Name:SERGEY
Middle Name:PAVLOVICH
Last Name:AKIMOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 GOODLETTE RD N STE 370
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5448
Mailing Address - Country:US
Mailing Address - Phone:239-624-0800
Mailing Address - Fax:239-624-9062
Practice Address - Street 1:800 GOODLETTE RD N STE 370
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5448
Practice Address - Country:US
Practice Address - Phone:239-624-0800
Practice Address - Fax:239-624-9062
Is Sole Proprietor?:No
Enumeration Date:2007-01-06
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36112645207RI0200X
FLME138743207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101720300Medicaid
FLD3LRHOtherBCBS
ILK38221Medicare PIN