Andrey Balykov, ATC ATL

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL4709 Issued in FL

Practice address

2204 Oasis Palm Cir Apt 405
Cape Coral, FL 33991-3391

Phone

(239) 560-9185

NPI assigned

Mar 22, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1043913908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8099 COLLEGE PKWY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 OASIS PALM CIR APT 405",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339913391",
            "telephone_number": "239-560-9185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALYKOV",
        "first_name": "ANDREY",
        "name_prefix": "Mr.",
        "credential": "ATC ATL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL4709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yaima Ballester Hidalgo, RBT
• Raymond Ballinger
• Saili Balmaceda Maceo
• Sahyli Balmaseda
• Elianet Baloy
• Bambi Lynn Macpherson
• Sheryl Ban
• Pablo Rodrigo Banderas, P.A.
• Bridget Yasmin Barahona
• Jose Rodrigo Barahona, MD

• Athletic Trainer in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.