MEDICARE: NANA GEGECHKORI MD. PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0001X	Clinical Cardiac Electrophysiology Physician	ME174264	FL

General Provider Information

NPI Number	:	1730611294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANA GEGECHKORI MD. PHD

Provider Business Mailing Address
First Line	:	4300 ALTON RD STE 2070
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2948
Country	:	US
Telephone Number	:	305-674-2690
Fax Number	:	305-674-2693

Provider Business Practice Location Address
First Line	:	4300 ALTON RD STE 2070
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2948
Country	:	US
Telephone Number	:	305-674-2690
Fax Number	:	305-674-2693

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2017
Last Update Date	:	03/03/2026

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