Provider Demographics
NPI:1932146842
Name:GEKHT, GENNADY (MD)
Entity Type:Individual
Prefix:
First Name:GENNADY
Middle Name:
Last Name:GEKHT
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 1:8000 SR 64 E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212
Mailing Address - Country:US
Mailing Address - Phone:941-792-1404
Mailing Address - Fax:941-795-1717
Practice Address - Street 1:8340 LAKEWOOD RANCH BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-5046
Practice Address - Country:US
Practice Address - Phone:974-792-1404
Practice Address - Fax:941-795-1717
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0535302084N0600X
FLME95933208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL17808OtherBCBS FLORIDA
FLAD963YMedicare PIN
FLAD963YMedicare PIN