Provider Demographics
NPI:1376683623
Name:GAUKHSHTEYN, NATASHA V (OD)
Entity Type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:V
Last Name:GAUKHSHTEYN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:33330 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3129
Mailing Address - Country:US
Mailing Address - Phone:727-789-0430
Mailing Address - Fax:727-786-3624
Practice Address - Street 1:33330 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3129
Practice Address - Country:US
Practice Address - Phone:727-789-0430
Practice Address - Fax:727-786-3624
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3343152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist