NICKOLOZ TCHANKOSHVILI M.D. NPI 1699088625

NPI Information

NPI: 1699088625
Provider Name: NICKOLOZ TCHANKOSHVILI, M.D.
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1414 E MAIN ST
LEESBURG, FL
ZIP 34748
Phone: (352) 728-3898
Get Directions

Nickoloz Tchankoshvili, M.D. is an obstetrics gynecology in Leesburg, FL. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Nickoloz Tchankoshvili, M.D. NPI is 1699088625. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1414 E MAIN ST
LEESBURG, FL
ZIP 34748-399
Phone: (352) 728-3898
Fax: (352) 728-6240

The NPI 1699088625 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/19/2010 and was last updated on 12/4/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	207V00000X	Obstetrics & Gynecology		ME120378	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	003150531A	MEDICAID	GEORGIA
2	012796400	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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