Provider Demographics
NPI:1215043203
Name:KOVACS, ENDRE (MD)
Entity Type:Individual
Prefix:DR
First Name:ENDRE
Middle Name:
Last Name:KOVACS
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 1:4592 E HIGHWAY 20 STE 3
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-9724
Mailing Address - Country:US
Mailing Address - Phone:850-279-6520
Mailing Address - Fax:850-897-1259
Practice Address - Street 1:4592 E HIGHWAY 20 STE 3
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-9724
Practice Address - Country:US
Practice Address - Phone:850-279-6520
Practice Address - Fax:850-897-1259
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78816207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJKO694199Medicare ID - Type Unspecified
G43429Medicare UPIN