Provider Demographics
NPI:1356476626
Name:BOVELSKY, CHRISTINA H (MD)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:H
Last Name:BOVELSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7341 OFFICE PARK PL STE 202B
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8280
Mailing Address - Country:US
Mailing Address - Phone:321-344-1270
Mailing Address - Fax:
Practice Address - Street 1:7341 OFFICE PARK PL STE 202B
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8280
Practice Address - Country:US
Practice Address - Phone:321-344-1270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME135456207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLKY532OtherMEDICARE
FL4EULYOtherBCBS