Provider Demographics
NPI:1619167954
Name:GACHIANI, JOHN MURAGE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MURAGE
Last Name:GACHIANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4321 N MACDILL AVE STE 407
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6396
Mailing Address - Country:US
Mailing Address - Phone:813-554-8690
Mailing Address - Fax:813-605-6068
Practice Address - Street 1:4321 N MACDILL AVE STE 407
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6396
Practice Address - Country:US
Practice Address - Phone:813-554-8690
Practice Address - Fax:813-605-6068
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.200930207T00000X
IA40396207T00000X, 208000000X
FLME151776207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No208000000XAllopathic & Osteopathic PhysiciansPediatrics