Individual
VADIM KATSENOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0077
Mailing address
1600 SW ARCHER RD, PO BOX 100254, GAINESVILLE, FL 32610-0254
(352) 273-8610
(352) 273-8612
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
91623
GA
207L00000X
Anesthesiology Physician
Primary
OS17485
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Enumeration date
03/23/2017
Last updated
06/02/2022
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