Healthcare Provider Details

I. General information

NPI: 1962327155
Provider Name (Legal Business Name): ADVANCED SURGICAL CARE AND ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 PINE RIDGE RD
NAPLES FL
34119-3900
US

IV. Provider business mailing address

1400 BLUE POINT AVE APT 201
NAPLES FL
34102-0589
US

V. Phone/Fax

Practice location:
  • Phone: 224-357-7463
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GENNADIY KATSEVMAN
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 224-357-7463